Provider Demographics
NPI:1982192746
Name:TANZER, DYLAN SHAWN (MD)
Entity Type:Individual
Prefix:MR
First Name:DYLAN
Middle Name:SHAWN
Last Name:TANZER
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:ERIE COUNTY MEDICAL CENTER, DK MILLER BUILDING
Mailing Address - Street 2:462 GRIDER STREET, 3RD FLOOR
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14215
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:ERIE COUNTY MEDICAL CENTER, DK MILLER BUILDING
Practice Address - Street 2:462 GRIDER STREET, 3RD FLOOR
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14215
Practice Address - Country:US
Practice Address - Phone:716-898-3627
Practice Address - Fax:716-898-5029
Is Sole Proprietor?:No
Enumeration Date:2018-04-27
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program