Basic Information
| Provider Information | |||||||||
| NPI: | 1225557465 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHWAB | ||||||||
| FirstName: | TYLER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 73 OAKDALE DR | ||||||||
| Address2: | |||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146181119 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 3800 RESERVOIR RD NW | ||||||||
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| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200072113 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2024442000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/19/2017 | ||||||||
| LastUpdateDate: | 10/29/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/29/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | C06571 | MD | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363A00000X | 0110005861 | VA | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363A00000X | PA031394 | DC | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.