Tyler Breck Martin
Nurse Practitioner - Family Medicine
725 Albany St Shapiro 3, Suite A
Boston
, Massachusetts 02118-2526
Tyler Breck Martin
Nurse Practitioner - Family Medicine
725 Albany St Shapiro 3, Suite A
Boston
, Massachusetts 02118-2526
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About
Features
Specialties
- Nurse Practitioner - Family Medicine
Languages spoken
- English
Location
First Address
- Tyler Breck Martin
- 720 Harrison Ave Dob 503
- Boston, MA
- Zip : 02118-2371
- Phone :
Second Address
- Tyler Breck Martin
- 725 Albany St Shapiro 3, Suite A
- Boston, MA
- Zip : 02118-2526
- Fax : (617) 414-3617
- Phone : (617) 414-4886
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LF0000X | Nurse Practitioner - Family Medicine | RN2282422 | MA |
National Provider Identifier
| NPI | 1003158122 |
|---|---|
| Provider Name | Tyler Breck Martin |
| First Address | Boston, MA 02118-2371 |
| Second Address | Boston, MA 02118-2526 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 27/03/2013 |
| Last Update Date | 28/09/2017 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 110105475A | (05) | MA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.