Provider Demographics
NPI:1376533125
Name:MURPHY, MADELON RUTH (DMD)
Entity Type:Individual
Prefix:DR
First Name:MADELON
Middle Name:RUTH
Last Name:MURPHY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:MADELON
Other - Middle Name:RUTH
Other - Last Name:MURPHY MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:455 CENTRAL PARK AVE
Mailing Address - Street 2:STE 309
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-1060
Mailing Address - Country:US
Mailing Address - Phone:914-874-5252
Mailing Address - Fax:914-874-5253
Practice Address - Street 1:455 CENTRAL PARK AVE
Practice Address - Street 2:STE 309
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-1060
Practice Address - Country:US
Practice Address - Phone:914-874-5252
Practice Address - Fax:914-874-5253
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-24
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0430271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1437336997OtherTYPE 2 NPI
NY01433632Medicaid