Healthcare Provider Details

I. General information

NPI: 1528032729
Provider Name (Legal Business Name): JENNIFER L KLOESZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 06/26/2024
Certification Date: 07/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 HALKET ST SUITE 4407
PITTSBURGH PA
15213-3108
US

IV. Provider business mailing address

300 HALKET ST SUITE 4407
PITTSBURGH PA
15213-3108
US

V. Phone/Fax

Practice location:
  • Phone: 412-641-4111
  • Fax:
Mailing address:
  • Phone: 412-641-4111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberMD063467L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD063467L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: