MEDICARE: CHRISTINA TAMASCO NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	2258917	MA

General Provider Information

NPI Number	:	1699077933
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA TAMASCO NP

Provider Business Mailing Address
First Line	:	940 BELMONT ST
Second Line	:
City	:	BROCKTON
State	:	MA
Zip	:	02301-5596
Country	:	US
Telephone Number	:	774-296-3249
Fax Number	:

Provider Business Practice Location Address
First Line	:	28 RIVERSIDE DR
Second Line	:
City	:	PEMBROKE
State	:	MA
Zip	:	02359-4947
Country	:	US
Telephone Number	:	781-826-8065
Fax Number	:	781-826-8043

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/18/2010
Last Update Date	:	05/18/2023

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