Healthcare Provider Details

I. General information

NPI: 1558885772
Provider Name (Legal Business Name): KAITLYN S LERSCH PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2017
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 5TH AVE STE 171A
PITTSBURGH PA
15222-3000
US

IV. Provider business mailing address

120 5TH AVE STE 171A
PITTSBURGH PA
15222-3000
US

V. Phone/Fax

Practice location:
  • Phone: 844-438-3226
  • Fax: 844-978-2756
Mailing address:
  • Phone: 844-438-3226
  • Fax: 844-978-2756

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number034383
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberMA059156
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: