Individual
JOHN TYLER NATHANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
51 W 51ST ST, NEW YORK, NY 10019-6113
(212) 305-1021
Mailing address
630 W 168TH ST # 4, NEW YORK, NY 10032-3725
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
321281
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/23/2017
Last updated
05/09/2023
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