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General NPI Number Information
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NPI Number | 1568906022
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Entity Type | Organization
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Legal Business Name | TYNER PHYSICAL THERAPY PLLC
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Dates
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Enumeration Date | 12/16/2016
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Last Update Date | 12/16/2022
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Provider Practice Location Address
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Address Line | 5 HARRISON ST
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City | NEW YORK
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State | NY
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Zip | 10013-2871
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Country | US
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Telephone | 516-521-0347
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Fax |
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Provider Business Mailing Address
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Address Line | 10 SLOCUM PL APT 4E
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City | BROOKLYN
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State | NY
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Zip | 11218-4364
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MEG NICOLE TYNER
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Credential | PT, DPT, ATC, CSCS
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Telephone | 516-521-0347
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 0397071
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License Number State | NY
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