Healthcare Provider Details

I. General information

NPI: 1245068287
Provider Name (Legal Business Name): REILEY KENNEDY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2024
Last Update Date: 06/27/2026
Certification Date: 06/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 GRANT ST FL 58
PITTSBURGH PA
15219-2739
US

IV. Provider business mailing address

600 GRANT ST FL 58
PITTSBURGH PA
15219-2739
US

V. Phone/Fax

Practice location:
  • Phone: 412-648-6200
  • Fax: 412-648-6358
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: