Provider Demographics
NPI:1356675730
Name:MURTHA, CYNTHIA M (PA-C)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:M
Last Name:MURTHA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:M
Other - Last Name:SMALLWOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:STONY BROOK UNIVERSITY HOSPITAL
Mailing Address - Street 2:HSC LEVEL 18 RM 080
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-0001
Mailing Address - Country:US
Mailing Address - Phone:631-444-2881
Mailing Address - Fax:631-444-7251
Practice Address - Street 1:STONY BROOK UNIVERSITY HOSPITAL
Practice Address - Street 2:HSC LEVEL 18 RM 080
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794
Practice Address - Country:US
Practice Address - Phone:631-459-9598
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-01
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015903363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP00817085Medicare PIN
PA169100FLTMedicare PIN