| Doctor Name: | DR. MARIE R. MAMMONE |
| NPI Number: | 1164446175 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | N.D. |
| License Number: | 000212 |
| Business Practice Address: | 274 Silas Deane Hwy Wethersfield, CT - 061091732 |
| Business Phone Number: | 8605291200 |
| Business Fax Number: | 8608821935 |
| Mailing Address: | 274 Silas Deane Hwy, WETHERSFIELD |
| State: | CT |
| Postal Code: | 061091732 |
| Phone Number: | 8605291200 |
| Fax Number: | 8608821935 |
| NPI Enumeration Date: | 07/26/2006 |
| NPI Last Update Date: | 10/07/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 000212 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |