Provider Demographics
NPI:1619393618
Name:SMARDZEWSKI, TYLER FINO (DC)
Entity Type:Individual
Prefix:DR
First Name:TYLER
Middle Name:FINO
Last Name:SMARDZEWSKI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2129 PULASKI HWY STE 103
Mailing Address - Street 2:
Mailing Address - City:HAVRE DE GRACE
Mailing Address - State:MD
Mailing Address - Zip Code:21078-2141
Mailing Address - Country:US
Mailing Address - Phone:443-327-6545
Mailing Address - Fax:
Practice Address - Street 1:2129 PULASKI HWY STE 103
Practice Address - Street 2:
Practice Address - City:HAVRE DE GRACE
Practice Address - State:MD
Practice Address - Zip Code:21078-2141
Practice Address - Country:US
Practice Address - Phone:443-327-6545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-14
Last Update Date:2014-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS03696111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor