Healthcare Provider Details

I. General information

NPI: 1699682666
Provider Name (Legal Business Name): TYLER CARNEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

231 GLENBROOK RD UNIT 4026
STORRS CT
06269-4026
US

IV. Provider business mailing address

180 BROAD ST APT 1204
STAMFORD CT
06901-2077
US

V. Phone/Fax

Practice location:
  • Phone: 860-486-3716
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number765810
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: