Provider Demographics
NPI:1982459426
Name:KAULFERS, TYLER
Entity Type:Individual
Prefix:
First Name:TYLER
Middle Name:
Last Name:KAULFERS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 RHODES AVE
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-2925
Mailing Address - Country:US
Mailing Address - Phone:908-956-2409
Mailing Address - Fax:
Practice Address - Street 1:1625 POPLAR ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-2648
Practice Address - Country:US
Practice Address - Phone:718-405-8562
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-18
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program