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General NPI Number Information
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NPI Number | 1306698550
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Entity Type | Individual
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Provider Name | KYLE ELY WOLFE CDN
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Gender | Male
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Dates
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Enumeration Date | 04/02/2024
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Last Update Date | 12/06/2025
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Provider Practice Location Address
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Address Line | 204 MEADOW RIDGE ACRES RD
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City | MILFORD
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State | PA
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Zip | 18337-7805
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Country | US
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Telephone | 914-799-2023
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Fax |
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Provider Business Mailing Address
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Address Line | 204 MEADOW RIDGE ACRES RD
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City | MILFORD
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State | PA
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Zip | 18337-7805
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Country | US
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Telephone | 914-799-2023
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number | 012026
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number | 012026
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number | DN008627
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | DN008627
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License Number State | PA
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Taxonomy #5
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number | DN008627
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License Number State | PA
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Taxonomy #6
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number | DN008627
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License Number State | PA
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Taxonomy #7
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number | 012026
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License Number State | NY
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Taxonomy #8
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | 012026
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License Number State | NY
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