Healthcare Provider Details

I. General information

NPI: 1922524768
Provider Name (Legal Business Name): MELANIE MURPHY ACUPUNCTURE P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2017
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

811 W JERICHO TPKE STE 203E
SMITHTOWN NY
11787-3220
US

IV. Provider business mailing address

PO BOX 528
SMITHTOWN NY
11787-0528
US

V. Phone/Fax

Practice location:
  • Phone: 631-319-9424
  • Fax:
Mailing address:
  • Phone: 631-319-9424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number003741
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number017811
License Number StateNY

VIII. Authorized Official

Name: MS. MELANIE JEAN MURPHY
Title or Position: PRESIDENT
Credential: L.AC., MS, L.M.T.
Phone: 631-319-9424