Healthcare Provider Details

I. General information

NPI: 1245149335
Provider Name (Legal Business Name): SHONDA MURPHY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 ATLANTIC AVE STE 110
LYNBROOK NY
11563-3051
US

IV. Provider business mailing address

351 ROQUETTE AVE
SOUTH FLORAL PARK NY
11001-3539
US

V. Phone/Fax

Practice location:
  • Phone: 516-884-9977
  • Fax:
Mailing address:
  • Phone: 516-884-9977
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number126652
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: