Individual
TYLER NORMILE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2621
(617) 724-4100
(617) 726-7415
Mailing address
55 FRUIT ST, BOSTON, MA 02114-2621
(617) 724-4100
(617) 726-7415
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0
—
MA
Enumeration date
06/04/2021
Last updated
09/30/2021
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