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NPI Code Detail

MEDICARE: JORDAN D. KALKSTEIN PA-C

MEDICARE: JORDAN D. KALKSTEIN PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician AssistantMA059411PA

General Provider Information

NPI Number : 1841700283
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORDAN D. KALKSTEIN PA-C
Provider Business Mailing Address
First Line : 363 S HIGHLAND AVE APT 303
Second Line :
City : PITTSBURGH
State : PA
Zip : 15206-4258
Country : US
Telephone Number : 412-841-8585
Fax Number :
Provider Business Practice Location Address
First Line : 6343 PENN AVE
Second Line :
City : PITTSBURGH
State : PA
Zip : 15206-4011
Country : US
Telephone Number : 412-363-2200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/11/2017
Last Update Date : 09/03/2020

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