MEDICARE: MS. CAROLYN C. MURPHY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	38508	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700150356
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CAROLYN C. MURPHY

Provider Business Mailing Address
First Line	:	60 OLD PONSETT RD
Second Line	:
City	:	HADDAM
State	:	CT
Zip	:	06438-1023
Country	:	US
Telephone Number	:	562-256-7550
Fax Number	:

Provider Business Practice Location Address
First Line	:	60 OLD PONSETT RD
Second Line	:
City	:	HADDAM
State	:	CT
Zip	:	06438-1023
Country	:	US
Telephone Number	:	562-256-7550
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/29/2012
Last Update Date	:	02/29/2012

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