Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Justin Tanco, IDC

Individual provider Independent Duty Corpsman · NPI 1255183067

Justin Tanco, IDC is an Independent Duty Corpsman in Groton, Connecticut. Registered with an NPI since 2024.

In the registry since
2024

Practice location Address checks out

Bldg 159 Trout Ave
Groton, CT 06349
Phone: (860) 694-2876
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Independent Duty Corpsman (primary) Taxonomy 1710I1002X

Record details

NPI number1255183067
Entity typeIndividual (Type 1)
GenderMale
Credentials IDC
Sole proprietorNo
NPI enumeratedApril 4, 2024
Last updated in NPPESApril 4, 2024
Certification dateApril 2, 2024

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