Individual
DR. TYLER CORY MANIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
703 MAIN ST, PATERSON, NJ 07503-2621
(321) 217-6797
Mailing address
500 WINDERLEY PL STE 115, MAITLAND, FL 32751-7406
(407) 875-0555
(407) 875-0244
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
1346654142
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/19/2014
Last updated
11/15/2019
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