National Provider Identifier
Tyler John Bogardus
Tyler John Bogardus is listed in the NPPES registry with a primary specialty of Pharmacist in Watkins Glen, NY and a listed phone number of (607) 535-7350.
Profile Overview
- NPI
- 1053778399
- Provider Type
- Individual
- Primary Specialty
- Pharmacist
- Enumeration Date
- January 18, 2016
- Last Updated
- January 18, 2016
Practice Location
- 506 S Franklin St
- Watkins Glen, NY 14891-1524
Phone: (607) 535-7350
Mailing Address
- 405 Fern RD
- Syracuse, NY 13219-2335
Specialties
- Pharmacist (183500000X)
Full Record
- NPI
- 1053778399
- Entity Type
- Individual
- Last Name
- Bogardus
- First Name
- Tyler
- Middle Name
- John
- Mailing Street Address
- 405 Fern RD
- Mailing City
- Syracuse
- Mailing State
- NY
- Mailing ZIP Code
- 13219-2335
- Mailing Country
- US
- Mailing Phone
- (315) 706-6282
- Practice Street Address
- 506 S Franklin St
- Practice City
- Watkins Glen
- Practice State
- NY
- Practice ZIP Code
- 14891-1524
- Practice Country
- US
- Practice Phone
- (607) 535-7350
- Enumeration Date
- January 18, 2016
- Last Updated
- January 18, 2016
- Sex
- Male
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Pharmacist (183500000X)