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1952726283 NPI number — PETER GREGORY TYSON JR. BA

NPI Number: 1952726283
Health Care Provider/Practitioner: PETER GREGORY TYSON JR. BA

Information about “1952726283” NPI (PETER GREGORY TYSON JR. BA) exists in 1952726283 in HTML format HTML  |  1952726283 in plain Text format TXT  |  1952726283 in PDF (Portable Document Format) PDF  |  1952726283 in an XML format XML  formats.

NPI Number : 1952726283 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1952726283",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "TYSON",
    "FirstName": "PETER",
    "MiddleName": "GREGORY",
    "NamePrefix": "MR.",
    "NameSuffix": "JR.",
    "Credential": "BA",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "590 6TH AVE",
    "SecondLineMailingAddress": "11TH FLOOR",
    "MailingAddressCityName": "NEW YORK",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "10011-2019",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "646-300-3213",
    "MailingAddressFaxNumber": "212-660-1344",
    "FirstLinePracticeLocationAddress": "848 E 37TH ST APT 1",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BROOKLYN",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "11210-1937",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "347-782-0345",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "02/24/2014",
    "LastUpdateDate": "01/06/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "104100000X",
        "TaxonomyName": "Social Worker",
        "LicenseNumber": "100834",
        "LicenseNumberStateCode": "NY",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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