Provider Demographics
NPI:1790819738
Name:RAZOR, TYLASHEL J
Entity Type:Individual
Prefix:
First Name:TYLASHEL
Middle Name:J
Last Name:RAZOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1135 NORTON RD
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:OH
Mailing Address - Zip Code:43119-8523
Mailing Address - Country:US
Mailing Address - Phone:614-419-1689
Mailing Address - Fax:
Practice Address - Street 1:1135 NORTON RD
Practice Address - Street 2:
Practice Address - City:GALLOWAY
Practice Address - State:OH
Practice Address - Zip Code:43119-8523
Practice Address - Country:US
Practice Address - Phone:614-419-1689
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2388509Medicaid