Provider Demographics
NPI:1003887001
Name:MURPHY-FIENGO, MARY SHEILA (DO)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:SHEILA
Last Name:MURPHY-FIENGO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 355
Mailing Address - Street 2:
Mailing Address - City:GALES FERRY
Mailing Address - State:CT
Mailing Address - Zip Code:06335-0355
Mailing Address - Country:US
Mailing Address - Phone:860-464-7274
Mailing Address - Fax:860-464-7404
Practice Address - Street 1:1527 ROUTE 12
Practice Address - Street 2:SUITE 1
Practice Address - City:GALES FERRY
Practice Address - State:CT
Practice Address - Zip Code:06335-1800
Practice Address - Country:US
Practice Address - Phone:860-464-7274
Practice Address - Fax:860-464-7404
Is Sole Proprietor?:No
Enumeration Date:2006-01-28
Last Update Date:2012-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000426207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001004267Medicaid
CT110005882Medicare ID - Type Unspecified
CT001004267Medicaid