Individual
TINA MARIE TKACZEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2150 MAIN STREET, SPRINGFIELD, MA 01104
(413) 739-5676
(413) 733-5860
Mailing address
2150 MAIN STREET, SPRINGFIELD, MA 01104
(413) 739-5676
(413) 733-5860
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
217600
MA
Other
Enumeration date
07/27/2006
Last updated
01/02/2015
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