Tyler Scott Gannon, PHARMD, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

068398-01 Issued in NY

Practice address

83 Vandenburgh Ave
Troy, NY 12180-6086

Phone

(518) 272-1355

NPI assigned

Nov 15, 2021

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy, Registered Pharmacist

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Eckerd Corporation

  • Community/Retail Pharmacy
  • Troy, NY
  • NPI 1790884955
  NPD (past)
• Eckerd Corporation

  • Community/Retail Pharmacy
  • Virginia Beach, VA
  • NPI 1982703120
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1636934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636934400000",
    "number": "1487310355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 VANDENBURGH AVE",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121806086",
            "telephone_number": "518-272-1355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 VANDENBURGH AVE",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121806086",
            "telephone_number": "518-272-1355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANNON",
        "first_name": "TYLER",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "PHARMD, RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-15",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "068398-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Christopher Gallo, DC
• Karen M Galluccio-Mott
• Tanisha Gang
• Denise Catherine Gangi-Pollacek, RPA-C
• Amanda Marie Gannon, MS OTR/L
• Frank Farrell Garcia, MD
• Karin Gardner, MSW, LICSW, LCSW
• Colin Gauert
• Catherine Ann Gayron, LCSW
• Kristi Geddis

• Pharmacist in Troy, NY
• Providers in Troy, NY by specialty
• Pharmacist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.