Provider Demographics
NPI:1447458054
Name:MURPHY, GLORIA H (RDH)
Entity type:Individual
Prefix:
First Name:GLORIA
Middle Name:H
Last Name:MURPHY
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:GLORIA
Other - Middle Name:
Other - Last Name:HERRERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:204-10 45TH ROAD
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11361-3119
Mailing Address - Country:US
Mailing Address - Phone:718-224-2348
Mailing Address - Fax:
Practice Address - Street 1:137-50 JAMAICA AVE
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11435-3610
Practice Address - Country:US
Practice Address - Phone:718-298-5100
Practice Address - Fax:718-298-5130
Is Sole Proprietor?:No
Enumeration Date:2007-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020692-1124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist