Provider Demographics
NPI:1699077933
Name:TAMASCO, CHRISTINA (NP)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:TAMASCO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:940 BELMONT ST
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-5596
Mailing Address - Country:US
Mailing Address - Phone:774-296-3249
Mailing Address - Fax:
Practice Address - Street 1:28 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:MA
Practice Address - Zip Code:02359-4947
Practice Address - Country:US
Practice Address - Phone:781-826-8065
Practice Address - Fax:781-826-8043
Is Sole Proprietor?:No
Enumeration Date:2010-11-18
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2258917363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily