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JUSTIN TANCO IDC
NPI 1255183067
Military Health Care Provider - Independent Duty Corpsman in Groton, CT

Active since April 04, 2024
BLDG. 159 TROUT AVE, GROTON, CT 06349(860) 694-2876 Get Directions Write a Review

NPPES record last updated: April 4, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Justin Tanco Idc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JUSTIN TANCO IDC (NPI 1255183067) is an individual independent duty corpsman provider in Groton, Connecticut and active in the NPI registry since April 2024.

NPPES Registry Identity

NPI1255183067
Entity TypeIndividualMale
Primary Taxonomy1710I1002X
Provider Legal NameJUSTIN TANCOCredential: IDC
Location AddressBLDG. 159 TROUT AVEGroton, CT 06349
Mailing AddressBldg. 159 Trout AveGroton, CT 06349 · (860) 694-2876
Phone(860) 694-2876
Sole ProprietorNo
Enumeration DateApril 4, 2024
NPPES CertifiedApril 2, 2024
✔ NPI 1255183067 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMilitary Health Care Provider · Independent Duty CorpsmanOther Service Providers
Taxonomy Code1710I1002X
Definition
A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals.
BLDG. 159 TROUT AVE, Groton, CT 06349
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Justin Tanco's NPI number?

The NPI number for Justin Tanco is 1255183067. It was assigned to this individual provider in the NPPES registry on April 4, 2024.

Where is Justin Tanco located?

Justin Tanco practices at Bldg. 159 Trout Ave, Groton, CT 06349. The listed phone number is (860) 694-2876.

What is Justin Tanco's specialty?

The primary specialty registered for this NPI is Military Health Care Provider, specializing in Independent Duty Corpsman, with taxonomy code 1710I1002X.

When was this NPI record last updated?

The NPPES record for Justin Tanco was last updated on April 4, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.