Pezalski, Tyler Adam

Pezalski, Tyler Adam is an individual health care provider with primary practice located at 1800 E Park Ave , State College PA 16803-6709. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Pezalski, Tyler Adam can be contacted via phone (814) 231-7100.

Contact Information

Primary practice address
1800 E Park Ave State College PA 16803-6709
Phone: (814) 231-7100
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 2012-02188 North Carolina
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 0101246832 Virginia
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X MD457219 Pennsylvania

Profile Details

NPI number 1760643472
LBN Legal business name Pezalski, Tyler Adam
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 24th, 2008
Last updated Sep 14th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760643472 NPPES
Pennsylvania MEDICAID 1031202100001

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