Healthcare Provider Details

I. General information

NPI: 1033688445
Provider Name (Legal Business Name): TATIANA TUMENIUK APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2018
Last Update Date: 04/11/2025
Certification Date: 04/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 BOSTON POST RD STE 202
ORANGE CT
06477-3229
US

IV. Provider business mailing address

235 BOSTON POST RD STE 202
ORANGE CT
06477-3229
US

V. Phone/Fax

Practice location:
  • Phone: 203-799-1252
  • Fax: 203-799-3252
Mailing address:
  • Phone: 203-799-1252
  • Fax: 203-799-3252

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number7923
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: