Healthcare Provider Details

I. General information

NPI: 1205303542
Provider Name (Legal Business Name): ANJA MURPHY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2018
Last Update Date: 10/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 MAIDEN LN
NEW YORK NY
10038-4811
US

IV. Provider business mailing address

346 BEMENT AVE
STATEN ISLAND NY
10310-2139
US

V. Phone/Fax

Practice location:
  • Phone: 212-683-6700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number610554-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: