Provider Demographics
NPI:1942282728
Name:MURPHY, JOHN V (PT)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:V
Last Name:MURPHY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1971 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203-5066
Mailing Address - Country:US
Mailing Address - Phone:518-869-6220
Mailing Address - Fax:518-869-6465
Practice Address - Street 1:1971 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-5066
Practice Address - Country:US
Practice Address - Phone:518-869-6220
Practice Address - Fax:518-869-6465
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2018-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017532174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYS87526Medicare UPIN
NYRA6093Medicare ID - Type Unspecified