Individual provider Active NPI

Marie Tammaro, APRN

  • Pediatric Nurse Practitioner
  • Trumbull, CT
National Provider Identifier
1164933792
Registry record updated Oct 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
7334 Issued in CT
Practice address
15 Corporate Dr
Trumbull, CT 06611-1351
Phone
(203) 452-6240
Fax
(203) 452-2296
NPI assigned
Oct 23, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 7334 CT Primary

Addresses

Primary practice location

15 Corporate Dr
Trumbull, CT 06611-1351

Mailing address

193 Connecticut Ave
West Haven, CT 06516-6851
Phone (203) 410-0095

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
7334CTMDSocial Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1508716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508716800000",
    "number": "1164933792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "193 CONNECTICUT AVE",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065166851",
            "telephone_number": "203-410-0095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 CORPORATE DR",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066111351",
            "telephone_number": "203-452-6240",
            "fax_number": "203-452-2296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAMMARO",
        "first_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-23",
        "last_updated": "2017-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CT",
            "license": "7334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trumbull, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.