Healthcare Provider Details

I. General information

NPI: 1285559252
Provider Name (Legal Business Name): TAMAZUR KARIM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

93 SHENNECOSSETT RD
GROTON CT
06340-5115
US

IV. Provider business mailing address

93 SHENNECOSSETT RD
GROTON CT
06340-5115
US

V. Phone/Fax

Practice location:
  • Phone: 860-245-9355
  • Fax:
Mailing address:
  • Phone: 860-245-9355
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number9456
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: