Provider Demographics
NPI:1356449524
Name:LAVIN MURPHY, GAIL (PA)
Entity Type:Individual
Prefix:MS
First Name:GAIL
Middle Name:
Last Name:LAVIN MURPHY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 MOSEMAN RD
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-4808
Mailing Address - Country:US
Mailing Address - Phone:845-279-5711
Mailing Address - Fax:
Practice Address - Street 1:666 STONELEIGH AVENUE
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512
Practice Address - Country:US
Practice Address - Phone:845-279-5711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4459363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP72175Medicare UPIN
NY5F492EE791Medicare PIN