Provider Demographics
NPI:1346619012
Name:MURPHY, DARYL (PT)
Entity Type:Individual
Prefix:
First Name:DARYL
Middle Name:
Last Name:MURPHY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:644 GOFFLE RD
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07506-3452
Mailing Address - Country:US
Mailing Address - Phone:973-636-7000
Mailing Address - Fax:973-304-0653
Practice Address - Street 1:644 GOFFLE RD
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:NJ
Practice Address - Zip Code:07506-3452
Practice Address - Country:US
Practice Address - Phone:973-636-7000
Practice Address - Fax:973-304-0653
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-23
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00808300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist