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General NPI Number Information
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NPI Number | 1164933792
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Entity Type | Individual
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Provider Name | MARIE TAMMARO APRN
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Gender | Female
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Dates
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Enumeration Date | 10/23/2017
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Last Update Date | 10/23/2017
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Provider Practice Location Address
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Address Line | 15 CORPORATE DR
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City | TRUMBULL
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State | CT
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Zip | 06611-1351
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Country | US
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Telephone | 203-452-6240
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Fax | 203-452-2296
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Provider Business Mailing Address
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Address Line | 193 CONNECTICUT AVE
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City | WEST HAVEN
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State | CT
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Zip | 06516-6851
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Country | US
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Telephone | 203-410-0095
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 7334
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License Number State | CT
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