Healthcare Provider Details

I. General information

NPI: 1720934326
Provider Name (Legal Business Name): TYLER EGLAUF
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2026
Last Update Date: 03/06/2026
Certification Date: 03/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 GREENRIDGE AVE STE 2K
WHITE PLAINS NY
10605-1266
US

IV. Provider business mailing address

30 GREENRIDGE AVE STE 2K
WHITE PLAINS NY
10605-1266
US

V. Phone/Fax

Practice location:
  • Phone: 914-703-9800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number014047
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: