Tily, Grace E

Tily, Grace E is an individual health care provider with primary practice located at 526 Old Liverpool Rd , Liverpool NY 13088-6238. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Tily, Grace E can be contacted via phone (315) 453-3911.

Contact Information

Primary practice address
526 Old Liverpool Rd Liverpool NY 13088-6238
Phone: (315) 453-3911
Fax: (315) 453-0197
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X

Profile Details

NPI number 1174786438
LBN Legal business name Tily, Grace E
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 8th, 2008
Last updated Jul 8th, 2008 - about 18 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 1174786438 NPPES
New York MEDICAID 01420800

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