Healthcare Provider Details

I. General information

NPI: 1902539653
Provider Name (Legal Business Name): MARGARET E TYNSKI NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARGARET E GERVAIS

II. Dates (important events)

Enumeration Date: 07/08/2022
Last Update Date: 01/24/2023
Certification Date: 01/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

199 PARK CLUB LN SUITE 100
WILLIAMSVILLE NY
14221-5269
US

IV. Provider business mailing address

3041 ORCHARD PARK RD SUITE C
ORCHARD PARK NY
14127-1238
US

V. Phone/Fax

Practice location:
  • Phone: 716-332-6834
  • Fax: 716-332-6856
Mailing address:
  • Phone: 716-674-3104
  • Fax: 716-674-0666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberF310677
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberF310677
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: