Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 028169 | CT |
NPI | 1003924457 |
---|---|
Provider Name | Dr. Maria Tasso |
First Address | Waterbury, CT 06708-2652 |
Second Address | Waterbury, CT 06708-2652 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2006 |
Last Update Date | 15/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010028169CT01 | BLUECROSS BLUESHIELD (01) | CT |
028169 | CONNECTICARE (01) | CT |
0R0486 | HEALTHNET (01) | CT |
NHP114 | OXFORD (01) | CT |