Healthcare Provider Details

I. General information

NPI: 1225779226
Provider Name (Legal Business Name): KALEY MARIE MOYER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2022
Last Update Date: 09/22/2025
Certification Date: 09/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

651 HOLIDAY DR STE 100
PITTSBURGH PA
15220-2740
US

IV. Provider business mailing address

4 ALLEGHENY CTR FL 7
PITTSBURGH PA
15212-5227
US

V. Phone/Fax

Practice location:
  • Phone: 412-922-8490
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS024916
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: