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Individual

MICHAEL L DIMINO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
501 IRONBRIDGE RD, STE 10, FREEHOLD, NJ 07728
(732) 431-2999
(732) 431-2993
Mailing address
PO BOX 536, VOORHEES, NJ 08043-0536
(856) 669-6050
(856) 651-0794

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
60657
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6273408
NJ
01
P00975975
RAILROAD MEDICARE PTAN
NJ
Enumeration date
07/17/2006
Last updated
08/28/2015
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