Provider Demographics
NPI:1679445498
Name:TUDOR, KYLE
Entity type:Individual
Prefix:
First Name:KYLE
Middle Name:
Last Name:TUDOR
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 1:129 S MAIN ST STE T
Mailing Address - Street 2:
Mailing Address - City:LEWISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17044-2386
Mailing Address - Country:US
Mailing Address - Phone:717-857-2321
Mailing Address - Fax:223-262-0962
Practice Address - Street 1:129 S MAIN ST STE T
Practice Address - Street 2:
Practice Address - City:LEWISTOWN
Practice Address - State:PA
Practice Address - Zip Code:17044-2386
Practice Address - Country:US
Practice Address - Phone:717-857-2321
Practice Address - Fax:223-262-0962
Is Sole Proprietor?:No
Enumeration Date:2025-09-22
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)