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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467585414 NPPES
Connecticut MEDICAID 004235900

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