Healthcare Provider Details

I. General information

NPI: 1992612568
Provider Name (Legal Business Name): CONNOR MCMURRAY DPT
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 MAPLE AVE
SMITHTOWN NY
11787-4900
US

IV. Provider business mailing address

9 VERNON LN
CENTEREACH NY
11720-2811
US

V. Phone/Fax

Practice location:
  • Phone: 631-543-0004
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number056219
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: