Provider Demographics
NPI:1255301784
Name:MURPHY, PATRICK T (DO)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:T
Last Name:MURPHY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 ROUTE 52
Mailing Address - Street 2:
Mailing Address - City:BEACON
Mailing Address - State:NY
Mailing Address - Zip Code:12508-1208
Mailing Address - Country:US
Mailing Address - Phone:845-838-2240
Mailing Address - Fax:845-838-2167
Practice Address - Street 1:560 ROUTE 52
Practice Address - Street 2:
Practice Address - City:BEACON
Practice Address - State:NY
Practice Address - Zip Code:12508-1208
Practice Address - Country:US
Practice Address - Phone:845-838-2240
Practice Address - Fax:845-838-2167
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-26
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1821172207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01454526Medicaid
NY01454526Medicaid
94F851Medicare ID - Type Unspecified