Provider Demographics
NPI:1750936274
Name:MELIN, TAMAR RAE (NP)
Entity type:Individual
Prefix:
First Name:TAMAR
Middle Name:RAE
Last Name:MELIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:TAMAR
Other - Middle Name:RAE
Other - Last Name:WILMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:29 HOSPITAL HILL RD STE 1400
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:CT
Mailing Address - Zip Code:06069-2095
Mailing Address - Country:US
Mailing Address - Phone:860-364-4000
Mailing Address - Fax:
Practice Address - Street 1:29 HOSPITAL HILL RD STE 1400
Practice Address - Street 2:
Practice Address - City:SHARON
Practice Address - State:CT
Practice Address - Zip Code:06069-2095
Practice Address - Country:US
Practice Address - Phone:860-364-7029
Practice Address - Fax:860-364-7079
Is Sole Proprietor?:No
Enumeration Date:2019-08-02
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT8894363LA2200X
NYF309284-01363LP2300X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care