Provider Demographics
NPI:1215097530
Name:TYLER, RICHARD ALLAN (RPH)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:ALLAN
Last Name:TYLER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 ROBIN CIR
Mailing Address - Street 2:
Mailing Address - City:TOLLAND
Mailing Address - State:CT
Mailing Address - Zip Code:06084-2903
Mailing Address - Country:US
Mailing Address - Phone:860-871-8452
Mailing Address - Fax:
Practice Address - Street 1:455 HARTFORD RD
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06040-5729
Practice Address - Country:US
Practice Address - Phone:860-649-9946
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT5271183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist