Provider Demographics
NPI:1720871924
Name:TAMBURRINO, KASSANDRA (PA-C)
Entity type:Individual
Prefix:
First Name:KASSANDRA
Middle Name:
Last Name:TAMBURRINO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 N PROSPECT STREET EXT
Mailing Address - Street 2:
Mailing Address - City:ANSONIA
Mailing Address - State:CT
Mailing Address - Zip Code:06401-3024
Mailing Address - Country:US
Mailing Address - Phone:203-516-8830
Mailing Address - Fax:
Practice Address - Street 1:105 N PROSPECT STREET EXT
Practice Address - Street 2:
Practice Address - City:ANSONIA
Practice Address - State:CT
Practice Address - Zip Code:06401-3024
Practice Address - Country:US
Practice Address - Phone:203-516-8830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program