1790776987 NPI number — TIMOTHY P MURPHY MD

Table of content: TIMOTHY P MURPHY MD (NPI 1790776987)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790776987 NPI number — TIMOTHY P MURPHY MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MURPHY
Provider First Name:
TIMOTHY
Provider Middle Name:
P
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1790776987
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/17/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20 CATAMORE BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EAST PROVIDENCE
Provider Business Mailing Address State Name:
RI
Provider Business Mailing Address Postal Code:
02914-1204
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
401-432-2520
Provider Business Mailing Address Fax Number:
401-432-2457

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
20 CATAMORE BLVD
Provider Second Line Business Practice Location Address:
RHODE ISLAND MEDICAL IMAGING
Provider Business Practice Location Address City Name:
EAST PROVIDENCE
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02914-1204
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
401-432-2520
Provider Business Practice Location Address Fax Number:
401-432-2457
Provider Enumeration Date:
11/04/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X , with the licence number:  7773 , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0204X , with the licence number: 07773 , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 003114915 . This is a "CT MED ASSISTANCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 007773 . This is a "TUFTS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 300067428 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3207773 . This is a "HEALTHY START" identifier . This identifiers is of the category "OTHER".
  • Identifier: 004699 . This is a "BLUE CHIP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7002880 . This is a "RIMEDICAL ASSISTANCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 720051101 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1600203 . This is a "UNITED HEALTH PLANS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3207773 . This is a "MASSMEDICAID" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7773 . This is a "FEPBLUE CROSS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 007002880 . This is a "HOSPITAL PIN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 007773 . This is a "BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000001988 . This is a "NHPRI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 240065 . This is a "RIHPILGRIM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 240153 . This is a "W & I PILGRIM" identifier . This identifiers is of the category "OTHER".




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