Healthcare Provider Details

I. General information

NPI: 1669273090
Provider Name (Legal Business Name): TYLER PARE PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2025
Last Update Date: 03/21/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CHARLTON MEMORIAL HOSPITAL 363 HIGHLAND AVE
FALL RIVER MA
02720
US

IV. Provider business mailing address

CHARLTON MEMORIAL HOSPITAL 363 HIGHLAND AVE
FALL RIVER MA
02720
US

V. Phone/Fax

Practice location:
  • Phone: 508-973-7041
  • Fax: 508-973-7065
Mailing address:
  • Phone: 508-973-7041
  • Fax: 508-973-7065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateMA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: