Basic Information
Provider Information
NPI: 1457975567
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MURPHY
FirstName: CLARE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.S., CCC-SLP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3892 VERTEX PATH APT 11
Address2:  
City: SYRACUSE
State: NY
PostalCode: 132095054
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 736 IRVING AVE
Address2:  
City: SYRACUSE
State: NY
PostalCode: 132101687
CountryCode: US
TelephoneNumber: 3154707111
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/04/2020
LastUpdateDate: 06/04/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/04/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
235Z00000X  Y Speech, Language and Hearing Service ProvidersSpeech-Language Pathologist 

No ID Information.


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