Provider Demographics
NPI:1366748360
Name:MURPHY, JUDITH FERN (RN)
Entity type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:FERN
Last Name:MURPHY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:JUDITH
Other - Middle Name:FERN
Other - Last Name:MARCUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:23 ANNANDALE RD
Mailing Address - Street 2:
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-1748
Mailing Address - Country:US
Mailing Address - Phone:631-269-7201
Mailing Address - Fax:
Practice Address - Street 1:16 GRANBY PL
Practice Address - Street 2:
Practice Address - City:RONKONKOMA
Practice Address - State:NY
Practice Address - Zip Code:11779-4931
Practice Address - Country:US
Practice Address - Phone:631-648-8293
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-08
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY391080-1163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics