Healthcare Provider Details

I. General information

NPI: 1518875764
Provider Name (Legal Business Name): KARMYN SUE TYLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11-20 46TH RD
LONG ISLAND CITY NY
11101-5322
US

IV. Provider business mailing address

PO BOX 387
NEW YORK NY
10031-0387
US

V. Phone/Fax

Practice location:
  • Phone: 917-310-3691
  • Fax:
Mailing address:
  • Phone: 917-310-3691
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number036517
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: