Provider Demographics
NPI:1639309040
Name:MURPHY, KIMBERLY SIMONS (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:SIMONS
Last Name:MURPHY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2660 MAIN ST
Mailing Address - Street 2:SUITE 309
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06606-5369
Mailing Address - Country:US
Mailing Address - Phone:203-337-4494
Mailing Address - Fax:203-337-4910
Practice Address - Street 1:2660 MAIN ST
Practice Address - Street 2:SUITE 309
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06606-5369
Practice Address - Country:US
Practice Address - Phone:203-337-4494
Practice Address - Fax:203-337-4910
Is Sole Proprietor?:No
Enumeration Date:2009-07-20
Last Update Date:2009-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002575225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001299107Medicaid
CT2V8333OtherHEALTHNET
CTZS224OtherOXFORD
CT010029910CT01OtherBLUE CROSS BLUE SHIELD
CT4351331OtherAETNA
CTZS224OtherOXFORD