Healthcare Provider Details

I. General information

NPI: 1982570933
Provider Name (Legal Business Name): KAITLIN GEDZ PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2025
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 S MAIN ST
JAMESTOWN NY
14701-6626
US

IV. Provider business mailing address

84 LUCKS LN
WARREN PA
16365-8639
US

V. Phone/Fax

Practice location:
  • Phone: 716-483-2320
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: