Provider Demographics
NPI:1679805394
Name:TAMLYN, SUZANNE KAYLE (DC)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:KAYLE
Last Name:TAMLYN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1560 ROUTE 376
Mailing Address - Street 2:
Mailing Address - City:WAPPINGERS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12590-6149
Mailing Address - Country:US
Mailing Address - Phone:845-656-6662
Mailing Address - Fax:
Practice Address - Street 1:254 ROUTE 17K
Practice Address - Street 2:SUITE 203
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-8343
Practice Address - Country:US
Practice Address - Phone:845-567-9190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-04
Last Update Date:2010-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX011973-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor