Provider Demographics
NPI:1215153176
Name:MADORE, TARRA JOY (DC)
Entity type:Individual
Prefix:DR
First Name:TARRA
Middle Name:JOY
Last Name:MADORE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:TARRA
Other - Middle Name:JOY
Other - Last Name:PIPARO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:67 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MILLTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08850-1851
Mailing Address - Country:US
Mailing Address - Phone:732-246-1151
Mailing Address - Fax:
Practice Address - Street 1:67 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MILLTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08850-1851
Practice Address - Country:US
Practice Address - Phone:732-246-1151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00555200111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJPI035264Medicare ID - Type Unspecified