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General NPI Number Information
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NPI Number | 1598249252
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Entity Type | Individual
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Provider Name | TYLER JOSEPH KENTON DPT
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Gender | Male
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Dates
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Enumeration Date | 09/19/2018
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Last Update Date | 10/07/2021
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Provider Practice Location Address
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Address Line | 666 BROADWAY LOWR LEVEL
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City | NEW YORK
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State | NY
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Zip | 10012-2317
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Country | US
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Telephone | 302-233-1210
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Fax | 332-777-1315
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Provider Business Mailing Address
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Address Line | 129 N 3RD ST APT 309
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City | BROOKLYN
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State | NY
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Zip | 11249-3980
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Country | US
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Telephone | 302-233-1210
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Fax | 332-777-1315
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 038370
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License Number State | NY
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