Provider Demographics
NPI:1407305899
Name:MURPHY, GREGORY THADDEUS
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:THADDEUS
Last Name:MURPHY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 ROSEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02864-3342
Mailing Address - Country:US
Mailing Address - Phone:401-369-9133
Mailing Address - Fax:
Practice Address - Street 1:42 ROSEWOOD LN
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:RI
Practice Address - Zip Code:02864-3342
Practice Address - Country:US
Practice Address - Phone:401-369-9133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-26
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI19271171WH0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications