Individual
DR. MARIE R. MAMMONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
N.D.
Contact information
Practice address
274 SILAS DEANE HWY, WETHERSFIELD, CT 06109-1732
(860) 529-1200
(860) 882-1935
Mailing address
274 SILAS DEANE HWY, WETHERSFIELD, CT 06109-1732
(860) 529-1200
(860) 882-1935
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
000212
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110000212CT01
ANTHEM BC/BS
CT
01
—
212000
CT CARE
CT
Enumeration date
07/26/2006
Last updated
10/07/2010
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