Provider Demographics
NPI:1871686113
Name:WARNER, KYLE (DPT)
Entity Type:Individual
Prefix:MR
First Name:KYLE
Middle Name:
Last Name:WARNER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:485 CENTRAL PARK W
Mailing Address - Street 2:#3F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-3322
Mailing Address - Country:US
Mailing Address - Phone:646-470-8615
Mailing Address - Fax:212-409-8204
Practice Address - Street 1:485 CENTRAL PARK W
Practice Address - Street 2:#3F
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-3322
Practice Address - Country:US
Practice Address - Phone:646-470-8615
Practice Address - Fax:212-409-8204
Is Sole Proprietor?:No
Enumeration Date:2006-10-01
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025701-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA100020001Medicare PIN