Individual
MRS. CHARLOTTE TYSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
462 GRIDER ST, BUFFALO, NY 14215-3021
(716) 898-1334
(716) 898-1313
Mailing address
462 GRIDER ST, BUFFALO, NY 14215-3021
(716) 898-1334
(716) 898-1313
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
386724
NY
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
163WP0809X
NY
Other
Enumeration date
03/10/2017
Last updated
03/10/2017
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