Provider Demographics
NPI:1427424092
Name:JAMES, TYRONE ANTHONY (LPN)
Entity type:Individual
Prefix:MR
First Name:TYRONE
Middle Name:ANTHONY
Last Name:JAMES
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 WESTFALL RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-4632
Mailing Address - Country:US
Mailing Address - Phone:585-685-3317
Mailing Address - Fax:
Practice Address - Street 1:30 WESTFALL RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-4632
Practice Address - Country:US
Practice Address - Phone:585-319-7430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-18
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY321241-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse