Individual
ELIZABETH L TYNAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
007056
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1750585386
GROUP NPI
CT
01
—
650001421
MEDICARE PTAN
CT
01
—
C03714
GROUP PTAN
CT
Enumeration date
12/01/2006
Last updated
02/25/2015
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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