Individual
DR. JOHN MARSHALL TYO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
219 BRYANT STREET, BUFFALO, NY 14222-2006
(716) 878-7109
(716) 888-3874
Mailing address
4511 HARLEM ROAD, SUITE 202, AMHERST, NY 14226-3822
(716) 839-6720
(716) 839-6740
Taxonomy
Speciality
Code
Description
License number
State
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
213803
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00020541001
UNIVERA
—
01
—
000525797001
BC/BS
—
05
—
0018460620001
—
PA
05
—
01988229
—
NY
01
—
040426001680
FIDELIS
—
01
—
3991525
IHA
—
Enumeration date
04/21/2006
Last updated
11/30/2016
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