Provider Demographics
NPI:1295484129
Name:KALAMASZ, GORDON (CRNP)
Entity type:Individual
Prefix:
First Name:GORDON
Middle Name:
Last Name:KALAMASZ
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 10TH ST
Mailing Address - Street 2:
Mailing Address - City:FREEDOM
Mailing Address - State:PA
Mailing Address - Zip Code:15042-1729
Mailing Address - Country:US
Mailing Address - Phone:724-407-8582
Mailing Address - Fax:
Practice Address - Street 1:1010 DELAFIELD RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15240-1005
Practice Address - Country:US
Practice Address - Phone:412-822-2222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-18
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP025572363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily