Provider Demographics
NPI:1134276652
Name:MURPHY, ALISA MARIE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:ALISA
Middle Name:MARIE
Last Name:MURPHY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
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Mailing Address - Street 1:2949 ERIE BLVD E
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13224-1442
Mailing Address - Country:US
Mailing Address - Phone:315-424-1430
Mailing Address - Fax:315-424-1779
Practice Address - Street 1:2949 ERIE BLVD E
Practice Address - Street 2:SUITE 110
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13224-1442
Practice Address - Country:US
Practice Address - Phone:315-424-1430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY011920363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant