=====================================================
General NPI Number Information
=====================================================
NPI Number | 1588355135
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KYLE LUDLOW WERNER
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/16/2023
-----------------------------------------------------
Last Update Date | 07/08/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1228 HIGHWAY 37 STE 5
-----------------------------------------------------
City | TOMS RIVER
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08755-4811
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-504-2309
-----------------------------------------------------
Fax | 732-286-0173
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 404 7TH AVE APT 3A
-----------------------------------------------------
City | ASBURY PARK
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07712-5429
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-245-6468
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 237700000X
-----------------------------------------------------
Taxonomy Name | Hearing Instrument Specialist
-----------------------------------------------------
License Number | 25MG00163800
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------