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NPI Code Detail

MEDICARE: KYLE EIBEN MS, OTR/L

MEDICARE: KYLE EIBEN MS, OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist0119010727VA
2225X00000XOccupational TherapistOT16911FL

General Provider Information

NPI Number : 1891022968
Entity Type Code : Individual
Provider Name (Legal Business Name) : KYLE EIBEN MS, OTR/L
Provider Business Mailing Address
First Line : 8865 TENBURY CT
Second Line :
City : BRISTOW
State : VA
Zip : 20136-2016
Country : US
Telephone Number : 814-882-0183
Fax Number :
Provider Business Practice Location Address
First Line : 1768 BUSINESS CENTER DR STE 330
Second Line :
City : RESTON
State : VA
Zip : 20190-4882
Country : US
Telephone Number : 703-679-7837
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/11/2009
Last Update Date : 02/23/2026

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