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Individual

LYNWOOD PERNELL MURPHY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
11630 SUTPHIN BLVD, JAMAICA, NY 11434-1527
(718) 322-2500
(718) 322-1880
Mailing address
11630 SUTPHIN BLVD, JAMAICA, NY 11434-1527
(718) 322-2500
(718) 322-1880

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2-31206
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02249145
NY
Enumeration date
05/22/2018
Last updated
06/16/2018
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