Mcgillicuddy, Tina Katsarikas
Mcgillicuddy, Tina Katsarikas is an individual health care provider with primary practice located at 400 Columbus Ave , New Haven CT 06519-1233. She recently has 3 registered licenses in different health care specialties including Dietary & Nutritional Service Providers / Dietitian, Registered, Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Pediatrics. Physician Assistants & Advanced Practice Nursing Providers / Pediatrics is her primary health care specialty. Mcgillicuddy, Tina Katsarikas can be contacted via phone (203) 503-3250.Contact Information
Primary practice address
400 Columbus Ave
New Haven CT 06519-1233
Phone: (203) 503-3250
Fax: (203) 503-3254
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dietary & Nutritional Service Providers / Dietitian, Registered | 133V00000X | 151957 | Tennessee |
| Nursing Service Providers / Registered Nurse | 163W00000X | 079084 | Connecticut |
| Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 363LP0200X | 003531 | Connecticut |
Profile Details
| NPI number | 1467585414 |
|---|---|
| LBN Legal business name | Mcgillicuddy, Tina Katsarikas |
| Credentials | APRN NURSE PRACTITIO |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 13th, 2007 |
| Last updated | Dec 12th, 2011 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1467585414 | NPPES |
| Connecticut | MEDICAID | 004235900 |
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