Provider Demographics
NPI:1952637563
Name:MURPHY, BRYAN EDWARD (CRNA, APN)
Entity Type:Individual
Prefix:MR
First Name:BRYAN
Middle Name:EDWARD
Last Name:MURPHY
Suffix:
Gender:M
Credentials:CRNA, APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:375 ENGLE ST
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-1823
Mailing Address - Country:US
Mailing Address - Phone:201-871-6073
Mailing Address - Fax:201-655-6159
Practice Address - Street 1:350 ENGLE ST
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-1808
Practice Address - Country:US
Practice Address - Phone:201-894-3238
Practice Address - Fax:201-894-0585
Is Sole Proprietor?:No
Enumeration Date:2009-11-02
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY524513-1163W00000X
NJ26NR12777100163W00000X
NJ26NJ00282100367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP00880128OtherRAILROAD MEDICARE
NJP00880128OtherRAILROAD MEDICARE