Provider Demographics
NPI:1144207341
Name:MURPHY, CYNTHIA LASSITER (PT)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:LASSITER
Last Name:MURPHY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2246 YAUPON DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-7329
Mailing Address - Country:US
Mailing Address - Phone:910-251-1818
Mailing Address - Fax:910-251-0462
Practice Address - Street 1:2246 YAUPON DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-7329
Practice Address - Country:US
Practice Address - Phone:910-251-1818
Practice Address - Fax:910-251-0462
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20002251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC250097AOtherMEDICARE GROUP
NC720779BMedicaid
NC0779BOtherBC/BS NC NUMBER