Healthcare Provider Details

I. General information

NPI: 1184123739
Provider Name (Legal Business Name): MARILYN BUTLER-MURPHY,DPM,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2018
Last Update Date: 02/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

849 PARK AVE
MANHASSET NY
11030-2842
US

IV. Provider business mailing address

849 PARK AVE
MANHASSET NY
11030-2842
US

V. Phone/Fax

Practice location:
  • Phone: 516-627-2724
  • Fax: 516-627-2749
Mailing address:
  • Phone: 516-627-2724
  • Fax: 516-627-2749

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier00842815
Identifier TypeMEDICAID
Identifier StateNY
Identifier Issuer

VIII. Authorized Official

Name: DR. MARILYN BUTLER-MURPHY
Title or Position: DOCTOR
Credential: DPM
Phone: 516-627-2724