Provider Demographics
NPI:1770761777
Name:KREIZENBECK, GRETCHEN MELAINE GRAFF (MD)
Entity type:Individual
Prefix:DR
First Name:GRETCHEN
Middle Name:MELAINE GRAFF
Last Name:KREIZENBECK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:GRETCHEN
Other - Middle Name:MELAINE
Other - Last Name:GRAFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:110 FORT COUCH RD STE 203
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15241-1030
Mailing Address - Country:US
Mailing Address - Phone:412-831-3300
Mailing Address - Fax:412-440-0271
Practice Address - Street 1:110 FORT COUCH RD STE 203
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15241-1030
Practice Address - Country:US
Practice Address - Phone:412-831-3300
Practice Address - Fax:412-440-0271
Is Sole Proprietor?:No
Enumeration Date:2008-02-01
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD451746207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD451746OtherMEDICAL LICENSE