Most Relevant Information
Provider Data
| NPI Number: | 1003513227 |
| Provider Name: | TYLER GREEN |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/08/2023 |
| Last Updated: | 02/08/2023 |
Provider Practice Location
50 COMMUNITY LN
LIBERTY
NY
127542851
Practice Location Phone/Fax
| Phone: | 8452925910 |
| Fax: |
Provider Mailing Location
PO BOX 590
LIBERTY
NY
127540590
Provider Mailing Phone/Fax
| Phone: | 8452925910 |
| Fax: | 8455132265 |