Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Tyler Ravener

Individual provider Pharmacist · NPI 1871217786

Dr. Tyler Ravener is a Pharmacist in Bohemia, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2022
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Practice location Address checks out

4761 Sunrise Hwy
Bohemia, NY 11716
Phone: (631) 567-1061
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pharmacist (primary) Taxonomy 183500000X · Licence 060967 (NY)

Record details

NPI number1871217786
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedOctober 4, 2022
Last updated in NPPESOctober 4, 2022
Certification dateSeptember 30, 2022
Mailing address4761 Sunrise Hwy, Bohemia, NY 11716

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