Provider Demographics
NPI:1912939505
Name:MURPHY, RICHARD EDWARD (PA)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:EDWARD
Last Name:MURPHY
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:90 CONSTITUTION RD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-2038
Mailing Address - Country:US
Mailing Address - Phone:617-242-6088
Mailing Address - Fax:201-447-8658
Practice Address - Street 1:223 N VAN DIEN AVE
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-2726
Practice Address - Country:US
Practice Address - Phone:201-447-8372
Practice Address - Fax:201-447-8658
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MP00129900363AS0400X
MA181363AS0400X
NH0591363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical