Provider Demographics
NPI:1689604019
Name:TYLER, ALLEN E (MD)
Entity Type:Individual
Prefix:
First Name:ALLEN
Middle Name:E
Last Name:TYLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 BERNVILLE RD
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19605-9453
Mailing Address - Country:US
Mailing Address - Phone:610-378-2779
Mailing Address - Fax:610-378-2778
Practice Address - Street 1:2494 BERNVILLE ROAD
Practice Address - Street 2:STE. G01
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19605
Practice Address - Country:US
Practice Address - Phone:610-378-2779
Practice Address - Fax:610-378-2778
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD024475E2084N0400X
PAMD204475E2084N0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000948890Medicaid
PA069575OtherHIGHMARK BLUE SHIELD
PA4456695OtherAETNA
MD614027OtherCAREFIRST MD BCBS
PA100491OtherGEISINGER
PA0055804000OtherAMERIHEALTH 65 PA
PA104876OtherJOHNS HOPKINS
PA000948890Medicaid
PAC28846Medicare UPIN
PA104876OtherJOHNS HOPKINS
MD614027OtherCAREFIRST MD BCBS
PA4456695OtherAETNA
PA130024361Medicare PIN