Healthcare Provider Details

I. General information

NPI: 1154290849
Provider Name (Legal Business Name): ROBERT J. KILTZ, M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2025
Last Update Date: 11/11/2025
Certification Date: 11/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 E YALE LOOP STE 200
IRVINE CA
92604-4697
US

IV. Provider business mailing address

195 INTREPID LN
SYRACUSE NY
13205-2544
US

V. Phone/Fax

Practice location:
  • Phone: 315-469-8700
  • Fax:
Mailing address:
  • Phone: 315-671-3045
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number
License Number State

VIII. Authorized Official

Name: MAUREEN HALL
Title or Position: DIRECTOR OF COMPLIANCE
Credential:
Phone: 315-671-3045