Provider Demographics
NPI:1275799207
Name:MURPHY, CONLETH GERRARD (MB BCH BAO)
Entity Type:Individual
Prefix:DR
First Name:CONLETH
Middle Name:GERRARD
Last Name:MURPHY
Suffix:
Gender:M
Credentials:MB BCH BAO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 MAIN ST APT 10P
Mailing Address - Street 2:ROOSEVELT ISLAND
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10044-0244
Mailing Address - Country:US
Mailing Address - Phone:917-520-8833
Mailing Address - Fax:
Practice Address - Street 1:425 MAIN ST APT 10P
Practice Address - Street 2:ROOSEVELT ISLAND
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10044-0244
Practice Address - Country:US
Practice Address - Phone:917-520-8833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-30
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY60P65454207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology