Tiffany Allen-Zunum, NP-C
Individual provider Active NPI Family Nurse Practitioner · New London, CT
NPI 1922434489 · NPPES record last updated Jul 28, 2022
Key facts
- NPI
- 1922434489
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 10185 (CT)
- Practice address
- 255 Hempstead St
New London, CT 06320-6290 - Phone
- (860) 437-4550
- NPI assigned
- Sep 16, 2013
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in RI, CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140303001257 | RI | Practitioner - Nurse Practitioner | 9931339462 | Reassigns benefits to 1 organization |
| I20220815002026 | CT | Practitioner - Nurse Practitioner | 9931339462 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10185 | CT | MD | Pharmacist |
| APRN00437 | RI | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Child and Family Agency of Southeastern Connecticut, Inc. | Current |
Accepting new patients | |
| South County Primary Care, Inc. | Current |
Accepting new patients |
Locations
255 Hempstead St
New London, CT 06320
7 Vauxhall St
New London, CT 06320
Phone (860) 442-2797
360 Kingstown Rd
Unit 104
Narragansett, RI 02882
Phone (401) 594-2200
360 Kingstown Rd
Narragansett, RI 02882
Phone (401) 783-6940
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | NPP37788 | RI | |
| Family Nurse Practitioner | 363LF0000X | APRN00437 | RI | |
| Family Nurse Practitioner | 363LF0000X | 10185 | CT | Yes |
Addresses
Primary practice location
255 Hempstead St
New London, CT 06320-6290
Mailing address
255 Hempstead St
New London, CT 06320-6290
Phone (860) 437-4550
Other providers in New London, CT
- Damian Joel Aguilar
- Sarah Ali
- Naser Adeeb Aljundi
- Allan V. Chaney, LLC
- Elizabeth K Allard
- Alison Lorraine Allen
- Audrey A Allen
- John Allen
- Allergy Associates of New London, PC
- Rosa Jacqueline Almonte
All providers in New London, CT · Family Nurse Practitioner in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 28, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.