Provider Demographics
NPI:1851549828
Name:DIMURRO, MADELINE MARIE (DO)
Entity Type:Individual
Prefix:DR
First Name:MADELINE
Middle Name:MARIE
Last Name:DIMURRO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 MILLTOWN RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07081-2411
Mailing Address - Country:US
Mailing Address - Phone:973-953-3540
Mailing Address - Fax:
Practice Address - Street 1:231 MILLTOWN RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07081-2411
Practice Address - Country:US
Practice Address - Phone:973-953-3540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-03
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB63923208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics