Provider Demographics
NPI:1871956391
Name:FRITZ, KADIE
Entity type:Individual
Prefix:
First Name:KADIE
Middle Name:
Last Name:FRITZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5830 ELLSWORTH AVE
Mailing Address - Street 2:STE 300
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15232-1778
Mailing Address - Country:US
Mailing Address - Phone:412-361-3950
Mailing Address - Fax:412-361-3901
Practice Address - Street 1:5601 CENTRE AVE.
Practice Address - Street 2:SUITE 360
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206
Practice Address - Country:US
Practice Address - Phone:412-361-3950
Practice Address - Fax:412-361-3901
Is Sole Proprietor?:No
Enumeration Date:2016-04-01
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA056456363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical