Provider Demographics
NPI:1710561170
Name:HUFF, KYLE (CPHT)
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:
Last Name:HUFF
Suffix:
Gender:M
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 CURTISS AVE
Mailing Address - Street 2:
Mailing Address - City:WEST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06516-5411
Mailing Address - Country:US
Mailing Address - Phone:203-710-9048
Mailing Address - Fax:
Practice Address - Street 1:85 MIDDLETOWN AVE
Practice Address - Street 2:
Practice Address - City:NORTH HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06473-3927
Practice Address - Country:US
Practice Address - Phone:203-865-3179
Practice Address - Fax:203-752-1164
Is Sole Proprietor?:No
Enumeration Date:2021-05-11
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0012348183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician