Provider Demographics
NPI:1760056758
Name:MURPHY, ELISE CATHERINE (MS, LAT, ATC)
Entity type:Individual
Prefix:MS
First Name:ELISE
Middle Name:CATHERINE
Last Name:MURPHY
Suffix:
Gender:F
Credentials:MS, LAT, ATC
Other - Prefix:MS
Other - First Name:ELISE
Other - Middle Name:CATHERINE
Other - Last Name:MURPHY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, LAT, ATC
Mailing Address - Street 1:10 MIRACLE MILE DRIVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-5851
Mailing Address - Country:US
Mailing Address - Phone:603-714-9881
Mailing Address - Fax:
Practice Address - Street 1:10 MIRACLE MILE DRIVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-5851
Practice Address - Country:US
Practice Address - Phone:585-895-9540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-14
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA39152255A2300X
NH15062255A2300X
NY48152255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Multi-Specialty