Provider Demographics
NPI:1528681947
Name:JUNGLES, KYLIE NIKOLE (MD)
Entity type:Individual
Prefix:
First Name:KYLIE
Middle Name:NIKOLE
Last Name:JUNGLES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 SOUTHWOODS BLVD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12211-2554
Mailing Address - Country:US
Mailing Address - Phone:518-434-1446
Mailing Address - Fax:518-434-0806
Practice Address - Street 1:8 SOUTHWOODS BLVD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12211-2554
Practice Address - Country:US
Practice Address - Phone:518-434-1446
Practice Address - Fax:518-434-0806
Is Sole Proprietor?:No
Enumeration Date:2020-05-20
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY336450-012080P0201X
IL036.165313207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology