Provider Demographics
NPI:1689102014
Name:VIOLA, KYLE JAMES (PA)
Entity type:Individual
Prefix:MR
First Name:KYLE
Middle Name:JAMES
Last Name:VIOLA
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 HOBART ST
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07660-1831
Mailing Address - Country:US
Mailing Address - Phone:201-440-0674
Mailing Address - Fax:
Practice Address - Street 1:714 10TH ST.
Practice Address - Street 2:
Practice Address - City:SECAUCUS
Practice Address - State:NJ
Practice Address - Zip Code:07660
Practice Address - Country:US
Practice Address - Phone:201-865-2050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-30
Last Update Date:2017-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant