Provider Demographics
NPI:1184632283
Name:MARRUZZI, TYBEE ANN (LICAC)
Entity Type:Individual
Prefix:MS
First Name:TYBEE
Middle Name:ANN
Last Name:MARRUZZI
Suffix:
Gender:F
Credentials:LICAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 VAUTRINOT AVE
Mailing Address - Street 2:
Mailing Address - City:HULL
Mailing Address - State:MA
Mailing Address - Zip Code:02045-1119
Mailing Address - Country:US
Mailing Address - Phone:617-515-5870
Mailing Address - Fax:
Practice Address - Street 1:164 CHIEF JUSTICE CUSHING HWY
Practice Address - Street 2:
Practice Address - City:COHASSET
Practice Address - State:MA
Practice Address - Zip Code:02025-1223
Practice Address - Country:US
Practice Address - Phone:781-383-8877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA210401171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist