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Individual

DR. TYLER WISE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
622 W 168TH ST PH 1-137, NEW YORK, NY 10032-3720
(212) 305-2500
Mailing address
622 W 168TH ST PH 1-137, NEW YORK, NY 10032-3720

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01096555A
IN

Other

Enumeration date
03/29/2021
Last updated
07/29/2025
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