TYLER JOHN LONGSTREET (NPI# 1124539044) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1124539044 |
Entity Type | Individual |
Full Name | TYLER JOHN LONGSTREET |
Practice Address |
1000 E Mountain Blvd Wilkes Barre PA 18711-0027 |
Mailing Address |
204 Crestwood Ave Clarks Summit PA 18411-1024 |
Practice Telephone | 5708087300 |
Mailing Telephone | 5705102655 |
Enumeration Date | 2017-10-18 |
Last Update Date | 2017-10-18 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AM0700X |
Physician Assistant Specialization: Medical |
MA059462 | PA | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
1000 E MOUNTAIN BLVD |
City | WILKES BARRE |
State | PA |
Zip Code | 18711-0027 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1841292943 | Robert A Rostock | Specialist | 1000 E Mountain Blvd, Wilkes Barre, PA 18711-0027 | 2005-06-02 |
1396342994 | Haley Stackhouse | Physician Assistant | 1000 E Mountain Blvd, Wilkes Barre, PA 18711-0027 | 2020-10-06 |
1346852670 | Nicholas John Preston | Pharmacist | 1000 E Mountain Blvd, Wilkes Barre, PA 18711-0001 | 2020-08-18 |
1497363816 | Ashley Hine | Surgery | 1000 E Mountain Blvd, Wilkes Barre, PA 18711-0027 | 2020-07-22 |
1851919971 | Chelsea Pieshefski | Physician Assistant | 1000 E Mountain Blvd, Wilkes Barre, PA 18711-0027 | 2020-07-07 |
1437776150 | Alyssa M Callela | Physician Assistant | 1000 E Mountain Blvd, Wilkes Barre, PA 18711-0027 | 2020-06-29 |
1679199848 | Gabrielle Cristina Roberts | Physician Assistant | 1000 E Mountain Blvd, Wilkes Barre, PA 18711-0027 | 2020-06-23 |
1194341602 | Kylie Morgan Verespy | Physician Assistant | 1000 E Mountain Blvd, Wilkes Barre, PA 18711-0001 | 2020-06-20 |
1346865680 | Jillian Theresa Butkiewicz | Physician Assistant | 1000 E Mountain Blvd, Wilkes Barre, PA 18711-0027 | 2020-06-12 |
1902426711 | Belinda Sibanda | Student in an Organized Health Care Education/Training Program | 1000 E Mountain Blvd, Wilkes Barre, PA 18711-0001 | 2020-04-22 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1467924274 | Leeann Kayal | Nurse Practitioner | 111 East End Boulevard, Wilkes Barre, PA 18711 | 2018-12-19 |
1336661701 | Patricia Dworak | Occupational Therapist | 1175 East Mountain Boulevard, Wilkes-barre, PA 18711 | 2017-07-07 |
1992160352 | Hope Danishanko | Social Worker | 111 East End Blvd, Wilkes Barre, PA 18711 | 2015-12-29 |
1477962785 | Jennifer L. Heck | Physical Therapist | 1140 Route 315, Suite 207, Wilkes-barre, PA 18711 | 2014-08-12 |
1821338807 | Melinda Flaim | Physical Therapist | 1555 East End Blvd, Wilkes Barre, PA 18711 | 2013-02-27 |
1598900953 | Elizabeth Patricia Keating | Pharmacist | 1000 East Mountain Drive, Wilkes Barre, PA 18711 | 2008-12-12 |
1457433294 | Christopher William O'brien | Specialist/Technologist | King's College, 133 North River Street, Wilkes-barre, PA 18711 | 2006-10-20 |
1821197450 | Louis Jay Freedman | Obstetrics & Gynecology | Valley Medical Building, 3rd Floor, 1010 East Mountain Boulevard, Wilkes-barre, PA 18711 | 2006-09-21 |
1730282625 | Natalia N Belikova | Internal Medicine | 1111 East End Boulvard, Wilkesbarre, PA 18711 | 2006-09-06 |
1609883628 | Va Medical Center | General Acute Care Hospital | 1111 East End Blvd., Wilkes-barre, PA 18711 | 2006-08-02 |
Find all providers in zip 18711 |
Taxonomy Code | 363AM0700X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Medical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609802099 | Karen Anne Tillotson | Physician Assistant | 1000 E Mountain Blvd # 37-31, Wilkes Barre, PA 18711-0027 | 2006-06-25 |
1396342994 | Haley Stackhouse | Physician Assistant | 1000 E Mountain Blvd, Wilkes Barre, PA 18711-0027 | 2020-10-06 |
1508405739 | Leah Alexandra Merrick | Physician Assistant | 575 N River St, Wilkes Barre, PA 18702-2634 | 2020-01-06 |
1699257576 | Kylen Larue | Physician Assistant | 1000 E Mountain Blvd, Wilkes Barre, PA 18711-0027 | 2018-09-06 |
1992256101 | Danielle Marie Yakup | Physician Assistant | 545 N River St, Suite 130, Wilkes Barre, PA 18702-2600 | 2016-10-23 |
1891248142 | Natalie Launchi | Physician Assistant | 1000 E Mountain Blvd, Critical Care Medicine, Wilkes Barre, PA 18711-0027 | 2016-08-03 |
1245600709 | Amy Marie Wierbowski | Physician Assistant | 1177 Highway 315 Blvd, Dolphin Plaza, Wilkes Barre, PA 18702-6928 | 2015-09-28 |
1538404058 | Katie Gad | Physician Assistant | 150 Mundy St, Mac Iv Building, Wilkes Barre, PA 18702-6830 | 2012-12-10 |
1457635278 | Kimberly Kenehan | Physician Assistant | 150 Mundy St, Mac Iv Building, Wilkes Barre, PA 18702-6830 | 2011-09-29 |
1194994459 | Eugenia Hopkins | Physician Assistant | 1000 East Mountain Blvd, Geisinger Wyoming Valley Cardiology Department, Wilkes Barre, PA 18711 | 2008-02-20 |
Find all providers in WILKES BARRE |
City | WILKES BARRE |
Zip Code | 18711 |
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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.