Individual
MR. KYLE RICHARD CIFARELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
92 COE AVE, EAST HAVEN, CT 06512-4716
(203) 815-6111
Mailing address
92 COE AVE, EAST HAVEN, CT 06512-4716
(203) 815-6111
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1356
STATE OF CONNECTICUT DEPARTMENT OF PUBLIC HEALTH
CT
01
—
200033249
BOARD OF CERTIFICATION FOR THE ATHLETIC TRAINER
—
Enumeration date
03/04/2018
Last updated
05/29/2019
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