Provider Demographics
NPI:1316583024
Name:MURDOCK-JOHNSON, LORIS M (APN)
Entity Type:Individual
Prefix:
First Name:LORIS
Middle Name:M
Last Name:MURDOCK-JOHNSON
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 BENJAMIN GRIGGS DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08823-1821
Mailing Address - Country:US
Mailing Address - Phone:732-735-8472
Mailing Address - Fax:732-951-0421
Practice Address - Street 1:741 MOUNT LUCAS RD
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-1911
Practice Address - Country:US
Practice Address - Phone:609-497-3327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-18
Last Update Date:2019-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ009805002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry