Provider Demographics
NPI:1588222046
Name:PISTNER, KYLE
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:
Last Name:PISTNER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 NIAGARA ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14213-2007
Mailing Address - Country:US
Mailing Address - Phone:716-844-0700
Mailing Address - Fax:716-884-0631
Practice Address - Street 1:1050 NIAGARA ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14213-2007
Practice Address - Country:US
Practice Address - Phone:716-884-0700
Practice Address - Fax:716-884-0631
Is Sole Proprietor?:No
Enumeration Date:2019-05-30
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor