Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | PT000444E | PA |
NPI | 1023150232 |
---|---|
Provider Name | Mrs. Regina Riordan Murphy |
First Address | Harrisburg, PA 17109-5679 |
Second Address | Harrisburg, PA 17109-5679 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01766945 | (05) | PA |