Ferguson, Tyler

Ferguson, Tyler is an individual health care provider with primary practice located at 41 Pacella Park Dr , Randolph MA 02368-1755. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Ferguson, Tyler can be contacted via phone (781) 440-0400.

Contact Information

Primary practice address
41 Pacella Park Dr Randolph MA 02368-1755
Phone: (781) 440-0400
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1215215504
LBN Legal business name Ferguson, Tyler
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 3rd, 2011
Last updated Aug 3rd, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1215215504 NPPES
Massachusetts MEDICAID 110026265

Popular Providers