Kelly, Tyler

Kelly, Tyler is an individual health care provider with primary practice located at 101 Dates Dr , Ithaca NY 14850-1342. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Kelly, Tyler can be contacted via phone (607) 274-4011.

Contact Information

Primary practice address
101 Dates Dr Ithaca NY 14850-1342
Phone: (607) 274-4011
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 301771 New York

Profile Details

NPI number 1689100935
LBN Legal business name Kelly, Tyler
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date May 5th, 2017
Last updated Jun 4th, 2020 - about 5 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.

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