Provider Demographics
NPI:1922524768
Name:MELANIE MURPHY ACUPUNCTURE P.C.
Entity Type:Organization
Organization Name:MELANIE MURPHY ACUPUNCTURE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, MS, LMT
Authorized Official - Phone:631-319-9424
Mailing Address - Street 1:PO BOX 528
Mailing Address - Street 2:
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-0528
Mailing Address - Country:US
Mailing Address - Phone:631-319-9424
Mailing Address - Fax:
Practice Address - Street 1:811 W JERICHO TPKE STE 203E
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-3220
Practice Address - Country:US
Practice Address - Phone:631-319-9424
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-14
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003741171100000X
NY017811225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYFW97438YMedicaid