Provider Demographics
NPI:1275044091
Name:TARMINA-D'ANGELO, MARY CHRISTINE
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:CHRISTINE
Last Name:TARMINA-D'ANGELO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:
Other - Last Name:D'ANGELO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:99 HARTFORD ST
Mailing Address - Street 2:
Mailing Address - City:MEDFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02052-1402
Mailing Address - Country:US
Mailing Address - Phone:508-359-2810
Mailing Address - Fax:
Practice Address - Street 1:231 FOREST STREET
Practice Address - Street 2:HOLLISTER HALL, 1ST FLOOR
Practice Address - City:BABSON PARK
Practice Address - State:MA
Practice Address - Zip Code:02457-0310
Practice Address - Country:US
Practice Address - Phone:781-239-6363
Practice Address - Fax:781-239-5069
Is Sole Proprietor?:No
Enumeration Date:2017-10-19
Last Update Date:2017-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN186122163WC1400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1400XNursing Service ProvidersRegistered NurseCollege Health