Individual
DR. TYLER ADAM PEZALSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1800 E PARK AVE, STATE COLLEGE, PA 16803-6709
(814) 231-7100
Mailing address
PO BOX 16, STATE COLLEGE, PA 16804-0016
(814) 466-5090
(814) 466-5095
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
0101246832
VA
207L00000X
Anesthesiology Physician
2012-02188
NC
207L00000X
Anesthesiology Physician
Primary
MD457219
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1031202100001
—
PA
Enumeration date
06/24/2008
Last updated
09/14/2016
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