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Individual
SARAH ELIZABETH TYLER
Active
Individual
SARAH ELIZABETH TYLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
028649
NY
363AM0700X
Medical Physician Assistant
28649
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
028649
NEW YORK STATE LICENSE
NY
Enumeration date
08/10/2022
Last updated
07/22/2023
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