Provider Demographics
NPI:1851439236
Name:MURPHY-KIVELL, DIANE (ATC)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:
Last Name:MURPHY-KIVELL
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:457 HAVILAND RD
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06903-3337
Mailing Address - Country:US
Mailing Address - Phone:203-968-8769
Mailing Address - Fax:
Practice Address - Street 1:11 FARM RD
Practice Address - Street 2:
Practice Address - City:NEW CANAAN
Practice Address - State:CT
Practice Address - Zip Code:06840-6626
Practice Address - Country:US
Practice Address - Phone:203-594-4613
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0002192255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer