Healthcare Provider Details

I. General information

NPI: 1730338088
Provider Name (Legal Business Name): MICHELE MURPHY M.S., R.D., CDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2008
Last Update Date: 09/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 E 68TH ST
NEW YORK NY
10065-4870
US

IV. Provider business mailing address

75 E END AVE MR#16
NEW YORK NY
10028-7909
US

V. Phone/Fax

Practice location:
  • Phone: 212-746-0850
  • Fax:
Mailing address:
  • Phone: 940-206-7716
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1004X
TaxonomyPediatric Nutrition Registered Dietitian
License Number48006354
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: