Provider Demographics
NPI:1225641731
Name:DILLON, KYLE (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:KYLE
Middle Name:
Last Name:DILLON
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:667 STONELEIGH AVE STE 11
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:NY
Mailing Address - Zip Code:10512-2454
Mailing Address - Country:US
Mailing Address - Phone:845-704-8331
Mailing Address - Fax:845-228-8984
Practice Address - Street 1:667 STONELEIGH AVE STE 11
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512-2454
Practice Address - Country:US
Practice Address - Phone:845-704-8331
Practice Address - Fax:845-228-8984
Is Sole Proprietor?:No
Enumeration Date:2020-08-25
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic