Individual
TYLER P SANSONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
20 PROSPECT AVE STE 907, HACKENSACK, NJ 07601-1989
(201) 342-2550
Mailing address
112 HOOVER AVE APT 4, EDISON, NJ 08837-2684
(908) 783-9130
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
NJ
Other
Enumeration date
06/10/2025
Last updated
08/09/2025
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