Individual
DR. WAKENDA KACHINA TYLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
622 W 168TH STREET, PH11-102, NEW YORK, NY 10032
(212) 305-4565
Mailing address
622 W 168TH ST PH 111130, NEW YORK, NY 10032-3720
(212) 305-5976
(212) 305-6193
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
229889
NY
Other
Enumeration date
06/05/2008
Last updated
03/13/2023
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