National Provider Identifier

Kyle Thomas Stolba, N/A

Kyle Thomas Stolba, N/A is listed in the NPPES registry with a primary specialty of Athletic Trainer in Ithaca, NY and a listed phone number of (631) 708-8952.

NPI 1427516863Ithaca, NYAthletic Trainer

Profile Overview

NPI
1427516863
Provider Type
Individual
Primary Specialty
Athletic Trainer
Enumeration Date
March 05, 2019
Last Updated
March 05, 2019

Practice Location

  • 953 Danby RD
  • Ithaca, NY 14850-7002

Phone: (631) 708-8952

Specialties

  • Athletic Trainer (2255A2300X)
  • Student in an Organized Health Care Education/Training Program (390200000X)
Full Record
NPI
1427516863
Entity Type
Individual
Last Name
Stolba
First Name
Kyle
Middle Name
Thomas
Credential
N/A
Mailing Street Address
953 Danby RD
Mailing City
Ithaca
Mailing State
NY
Mailing ZIP Code
14850-7002
Mailing Country
US
Mailing Phone
(631) 708-8952
Practice Street Address
953 Danby RD
Practice City
Ithaca
Practice State
NY
Practice ZIP Code
14850-7002
Practice Country
US
Practice Phone
(631) 708-8952
Enumeration Date
March 05, 2019
Last Updated
March 05, 2019
Sex
Male
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Athletic Trainer (2255A2300X), Student in an Organized Health Care Education/Training Program (390200000X)