MEDICARE: TAYLOR ALLISON LYLE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN745334	PA

General Provider Information

NPI Number	:	1417891326
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLOR ALLISON LYLE

Provider Business Mailing Address
First Line	:	110 N 8TH ST APT 3L
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11249-2852
Country	:	US
Telephone Number	:	818-640-8122
Fax Number	:

Provider Business Practice Location Address
First Line	:	110 N 8TH ST APT 3L
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11249-2852
Country	:	US
Telephone Number	:	818-640-8122
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/20/2026
Last Update Date	:	04/20/2026

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