Michael Tyson
NPI 1184147142 · on the registry since 2017 · sole proprietor
Practice
- Address
- 696 Woodbine Ave
Rochester, NY 14619 - Phone
- (585) 532-0636
Additional practice sites
- 696 Woodbine Ave, Rochester, NY
Registry record
- Primary taxonomy
- Driver
172A00000X
- Licence states on file
- NY
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2022-07-21
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New York