TYLER KENNETH ANDERSON MD
NPI 1295406668
Student in an Organized Health Care Education/Training Program in Stony Brook, NY

Q: What is Tyler Anderson's NPI number?

The NPI number for Tyler Anderson is 1295406668. It was assigned to this individual provider in the NPPES registry on September 24, 2021.

Q: What is Tyler Anderson's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Tyler Anderson was last updated on March 23, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 24, 2021

101 NICOLLS RD, STONY BROOK, NY 11794(631) 444-1487 Get Directions Write a Review

NPPES record last updated: March 23, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 23, 2023, Sep 24, 2021 (2 updates tracked since 2021).

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About Tyler Kenneth Anderson Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TYLER KENNETH ANDERSON MD (NPI 1295406668) is an individual student in an organized health care education/training program in Stony Brook, New York and active in the NPI registry since September 2021.

NPPES Registry Identity

NPI1295406668

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameTYLER KENNETH ANDERSONCredential: MD

Location Address101 NICOLLS RDStony Brook, NY 11794-7800

Mailing Address101 Nicolls RdStony Brook, NY 11794

Phone(631) 444-1487

Sole ProprietorNo

Enumeration DateSeptember 24, 2021

Last NPPES UpdateMarch 23, 20232 updates tracked since enumeration

NPPES CertifiedMarch 23, 2023

✔ NPI 1295406668 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

101 NICOLLS RD, Stony Brook, NY 11794

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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