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Chanel Tyson

NPI 1396611521 · on the registry since 2025 · sole proprietor

Practice

Address
15c Hemlock Dr Apt 28
Bay Shore, NY 11706
Phone
(917) 687-4198

Registry record

Primary taxonomy
164W00000X
164W00000X
Licence states on file
NY
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2025-10-14

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