Healthcare Provider Details

I. General information

NPI: 1043295850
Provider Name (Legal Business Name): ANNEMARIE THERESA MURPHY PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2005
Last Update Date: 10/18/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1057 BROAD STREET SUITE 304
BRIDGEPORT CT
06604-4219
US

IV. Provider business mailing address

22 WOODCREST LN UNIT 22
DANBURY CT
06810-7143
US

V. Phone/Fax

Practice location:
  • Phone: 203-895-0311
  • Fax: 203-366-6525
Mailing address:
  • Phone: 203-459-0515
  • Fax: 203-336-6525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number001992
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number01992
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number001992
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: