Provider Demographics
NPI:1699711028
Name:TRAMONTOZZI, MARK EDWARD (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:EDWARD
Last Name:TRAMONTOZZI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:330 WASHINGTON ST
Mailing Address - Street 2:SUITE 520
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360-2700
Mailing Address - Country:US
Mailing Address - Phone:860-889-3841
Mailing Address - Fax:860-887-3840
Practice Address - Street 1:330 WASHINGTON ST
Practice Address - Street 2:SUITE 520
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360-2700
Practice Address - Country:US
Practice Address - Phone:860-889-3841
Practice Address - Fax:860-887-3840
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT030790208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1292510-002OtherCIGNA
CT010030790CT01OtherANTHEM BCBS
CT307900OtherCONNECTICARE
CT001307900Medicaid
CT668514OtherTUFTS HEALTH PLAN
CTNLS062OtherOXFORD
CT031273OtherHEALTH NET
CT020038549OtherRAILROAD MEDICARE
CT1022018OtherAETNA
CT182032OtherPREFERRED ONE
CT668514OtherTUFTS HEALTH PLAN
CT182032OtherPREFERRED ONE