Provider Demographics
NPI:1376561746
Name:MURPHY, JANINE
Entity Type:Individual
Prefix:
First Name:JANINE
Middle Name:
Last Name:MURPHY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JANINE
Other - Middle Name:
Other - Last Name:BLANCO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6 IVY ST
Mailing Address - Street 2:
Mailing Address - City:FARMINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11735-2300
Mailing Address - Country:US
Mailing Address - Phone:516-314-3785
Mailing Address - Fax:
Practice Address - Street 1:5 TEE VIEW CT
Practice Address - Street 2:
Practice Address - City:MANORVILLE
Practice Address - State:NY
Practice Address - Zip Code:11949-2939
Practice Address - Country:US
Practice Address - Phone:631-874-3032
Practice Address - Fax:631-874-4105
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025761-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist