Provider Demographics
NPI:1174738181
Name:KAVROS, PEREGRINE MURPHY (PHD)
Entity type:Individual
Prefix:DR
First Name:PEREGRINE
Middle Name:MURPHY
Last Name:KAVROS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1311 LAWRENCE RD
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NC
Mailing Address - Zip Code:27278-8519
Mailing Address - Country:US
Mailing Address - Phone:914-420-6448
Mailing Address - Fax:
Practice Address - Street 1:1311 LAWRENCE RD
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NC
Practice Address - Zip Code:27278-8519
Practice Address - Country:US
Practice Address - Phone:914-420-6448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-12
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4870103G00000X, 103TB0200X, 103TH0100X
NY016313-1103G00000X, 103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Provider Identifiers
StateIdentifier IDID TypeIssuer
11496523OtherCAQH