Provider Demographics
NPI:1154191179
Name:MAHR-TYLER, NANCY ANNA
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:ANNA
Last Name:MAHR-TYLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4517 WILCOX PL
Mailing Address - Street 2:
Mailing Address - City:JAMESVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13078-9531
Mailing Address - Country:US
Mailing Address - Phone:315-415-6644
Mailing Address - Fax:
Practice Address - Street 1:115 CONTINUUM DR
Practice Address - Street 2:
Practice Address - City:LIVERPOOL
Practice Address - State:NY
Practice Address - Zip Code:13088-4387
Practice Address - Country:US
Practice Address - Phone:315-450-4898
Practice Address - Fax:315-449-9898
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-02
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist