Provider Demographics
NPI:1841700283
Name:KALKSTEIN, JORDAN D (PA-C)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:D
Last Name:KALKSTEIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:JORDAN
Other - Middle Name:DENISE
Other - Last Name:MELE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:363 S HIGHLAND AVE APT 303
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-4258
Mailing Address - Country:US
Mailing Address - Phone:412-841-8585
Mailing Address - Fax:
Practice Address - Street 1:6343 PENN AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-4011
Practice Address - Country:US
Practice Address - Phone:412-363-2200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-11
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA059411363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical