Provider Demographics
NPI:1457606667
Name:TYLER, DENISE B (R PH)
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:B
Last Name:TYLER
Suffix:
Gender:F
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18578 COASTAL HWY
Mailing Address - Street 2:
Mailing Address - City:REHOBOTH BEACH
Mailing Address - State:DE
Mailing Address - Zip Code:19971-6154
Mailing Address - Country:US
Mailing Address - Phone:302-644-1903
Mailing Address - Fax:
Practice Address - Street 1:18578 COASTAL HWY
Practice Address - Street 2:
Practice Address - City:REHOBOTH BEACH
Practice Address - State:DE
Practice Address - Zip Code:19971-6154
Practice Address - Country:US
Practice Address - Phone:302-644-1903
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-13
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03463500183500000X
PARP030061L183500000X
DEA1-0004213183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist