Healthcare Provider Details

I. General information

NPI: 1245792456
Provider Name (Legal Business Name): KYLIE NICOLE GRADY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2019
Last Update Date: 03/17/2026
Certification Date: 03/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3471 FIFTH AVE KAUFMANN BLDG 4TH FLR SUITE 402
PITTSBURGH PA
15213
US

IV. Provider business mailing address

3600 FORBES AVE
PITTSBURGH PA
15213-3410
US

V. Phone/Fax

Practice location:
  • Phone: 412-692-4540
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD483124
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: