Provider Demographics
NPI:1619935186
Name:MURPHY, RYAN M (PA-C)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:M
Last Name:MURPHY
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 30
Mailing Address - Street 2:
Mailing Address - City:STOUGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02072-0030
Mailing Address - Country:US
Mailing Address - Phone:781-344-3535
Mailing Address - Fax:508-535-0192
Practice Address - Street 1:15 ROCHE BROS. WAY
Practice Address - Street 2:
Practice Address - City:NORTH EASTON
Practice Address - State:MA
Practice Address - Zip Code:02356
Practice Address - Country:US
Practice Address - Phone:781-344-3535
Practice Address - Fax:508-535-0192
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPA1709363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAAP2070Medicare ID - Type Unspecified
Q08446Medicare UPIN