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Individual

TARSILLA WITKOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
100 TER HEUN DR, FALMOUTH, MA 02540
(508) 548-5300
(508) 548-5789
Mailing address
PO BOX 676, LEWISTON, ME 04243-0676
(800) 720-1664
(207) 753-2020

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
163927
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00422245
RAILROAD MEDICARE
Enumeration date
09/26/2006
Last updated
12/11/2007
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