Individual
TYLER DAVID PHELAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
20 YORK ST, NEW HAVEN, CT 06510-3220
(530) 219-9097
Mailing address
207 GEORGE ST APT 110, MIDDLETOWN, CT 06457-3591
(530) 219-9097
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
4042
CT
Other
Enumeration date
03/15/2018
Last updated
03/15/2018
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