Provider Demographics
NPI:1821637653
Name:TYLER J KENTON DPT PLLC
Entity Type:Organization
Organization Name:TYLER J KENTON DPT PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:KENTON
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:302-233-1210
Mailing Address - Street 1:129 N 3RD ST APT 309
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11249-3980
Mailing Address - Country:US
Mailing Address - Phone:302-233-1210
Mailing Address - Fax:332-777-1315
Practice Address - Street 1:666 BROADWAY LOWR LEVEL
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-2317
Practice Address - Country:US
Practice Address - Phone:302-233-1210
Practice Address - Fax:332-777-1315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-26
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty