Provider Demographics
NPI:1801276977
Name:TYLER, MEGAN (RD)
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:
Last Name:TYLER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 BUSINESS PARK DRIVE
Mailing Address - Street 2:UTICA BUSINSS PARK
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502
Mailing Address - Country:US
Mailing Address - Phone:315-793-2800
Mailing Address - Fax:315-793-2807
Practice Address - Street 1:118 BUSINESS PARK DRIVE
Practice Address - Street 2:UTICA BUSINSS PARK
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502
Practice Address - Country:US
Practice Address - Phone:315-793-2800
Practice Address - Fax:315-793-2807
Is Sole Proprietor?:No
Enumeration Date:2015-06-04
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1016666133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered