Provider Demographics
NPI:1942893326
Name:MIHALIK, KYLE
Entity Type:Individual
Prefix:MR
First Name:KYLE
Middle Name:
Last Name:MIHALIK
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 1:10 BUIST RD STE 305
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:PA
Mailing Address - Zip Code:18337-9311
Mailing Address - Country:US
Mailing Address - Phone:570-832-4888
Mailing Address - Fax:
Practice Address - Street 1:10 BUIST RD STE 305
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:PA
Practice Address - Zip Code:18337-9311
Practice Address - Country:US
Practice Address - Phone:570-832-4888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-16
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA171046156F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156F00000XEye and Vision Services ProvidersTechnician/Technologist