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General NPI Number Information
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NPI Number | 1033104765
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Entity Type | Individual
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Provider Name | DARREN SCOTT TISHLER MD
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Gender | Male
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Dates
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Enumeration Date | 09/19/2005
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Last Update Date | 03/29/2011
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Provider Practice Location Address
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Address Line | 330 WESTERN BLVD
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City | GLASTONBURY
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State | CT
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Zip | 06033-1236
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Country | US
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Telephone | 860-246-2071
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Fax | 860-524-2650
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Provider Business Mailing Address
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Address Line | 85 SEYMOUR ST STE 415
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City | HARTFORD
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State | CT
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Zip | 06106-5501
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Country | US
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Telephone | 860-246-2071
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Fax | 860-524-2650
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 042514
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License Number State | CT
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