TYLER GARDINER (NPI# 1063035616) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063035616 |
| Entity Type | Individual |
| Full Name | TYLER GARDINER |
| Practice Address |
61 Green St Watertown MA 02472-2351 |
| Practice Telephone | 6179243794 |
| Mailing Telephone | 6179243794 |
| Enumeration Date | 2020-05-18 |
| Last Update Date | 2020-05-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
61 GREEN ST |
| City | WATERTOWN |
| State | MA |
| Zip Code | 02472-2351 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548735327 | Gladys Nakungu Kasansula | Counselor | Square Medical Group, 124 Watertown Street, Suite 2d, Watertown, MA 02472 | 2018-10-09 |
| 1447741962 | Hannah Edward | Optometrist | 550 Arsenal Street, Watertown, MA 02472 | 2018-05-21 |
| 1982193504 | Ruth Audrey Silverstein | Social Worker | Perkins School for The Blind, 175 North Beacon Street, Watertown, MA 02472 | 2018-05-09 |
| 1376067355 | Mostafa Medhati | Acupuncturist | 265 Lexington St., Watertown, MA 02472 | 2017-08-01 |
| 1003346313 | Eric Trant | Specialist/Technologist | 50 Columbia Street, Watertown, MA 02472 | 2017-06-19 |
| 1477007730 | Neangkanika Chea | Nurse Practitioner | 2 Repton Place, Apt 2204, Watertown, MA 02472 | 2016-08-04 |
| 1396128120 | Michelle Soares Darocha | Dentist | 18 Hovey Street, Watertown, MA 02472 | 2015-06-29 |
| 1760875496 | Ece Evin Yildirim | Acupuncturist | 557 Mt. Auburn St, Watertown, MA 02472 | 2015-03-05 |
| 1396140927 | Fabrizia Torazzi | Behavioral Analyst | 51 Water Street, Suite 200, Watertown, MA 02472 | 2014-10-24 |
| 1265774392 | Emilia Ann Fulop | Social Worker | 127 North Beacon Street, Watertown, MA 02472 | 2013-03-27 |
| Find all providers in zip 02472 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| 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. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730795147 | Suong Bui | Student in an Organized Health Care Education/Training Program | 141 Breen Ave, Watertown, NY 13601-7394 | 2020-09-21 |
| 1871113605 | Jairo Matthew Amarillo | Student in an Organized Health Care Education/Training Program | 203 Sycamore St Unit 2, Watertown, MA 02472-1058 | 2020-04-22 |
| 1649899592 | Tara Toloui Rahimabadi | Student in an Organized Health Care Education/Training Program | 275 Main St Apt 704, Watertown, MA 02472-4309 | 2020-04-10 |
| 1710516117 | Karla Bakke | Student in an Organized Health Care Education/Training Program | 117 Riverlawn Ave, Watertown, WI 53094-4013 | 2020-04-07 |
| 1790327963 | Michelle Blitzman | Student in an Organized Health Care Education/Training Program | 2c Locust Ln, Watertown, MA 02472-1733 | 2019-10-09 |
| 1639664634 | Angela Tutein | Student in an Organized Health Care Education/Training Program | 11a Cuba St, Watertown, MA 02472-2342 | 2018-06-22 |
| 1811310428 | Ryan Renzella | Student in an Organized Health Care Education/Training Program | 48 Prospect St, Watertown, MA 02472-3113 | 2014-02-03 |
| 1073891222 | Alexander Pantelis Tinios | Student in an Organized Health Care Education/Training Program | 163 Townline Hwy, Watertown, CT 06795 | 2011-07-21 |
| 1992316657 | Michele Kolb | Student in an Organized Health Care Education/Training Program | 211 J.b. Wise Plaza, Watertown, NY 13601 | 2020-08-14 |
| 1518578368 | Brieanna Lewis | Student in an Organized Health Care Education/Training Program | 211 J.b. Wise Plaza, Watertown, NY 13601-1360 | 2020-08-14 |
| Find all providers in WATERTOWN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.