Provider Demographics
NPI:1922250687
Name:MURPHY, MARY LELIA (LAC, RN)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:LELIA
Last Name:MURPHY
Suffix:
Gender:F
Credentials:LAC, RN
Other - Prefix:MS
Other - First Name:MARILEE
Other - Middle Name:
Other - Last Name:MURPHY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:520 W GREEN ST
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-5252
Mailing Address - Country:US
Mailing Address - Phone:607-319-0888
Mailing Address - Fax:
Practice Address - Street 1:520 W GREEN ST
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-5252
Practice Address - Country:US
Practice Address - Phone:607-319-0888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-14
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000234171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist