Provider Demographics
NPI:1093297665
Name:ALI, KAYLA
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:ALI
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 1:5725 FORWARD AVE STE 401
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-2255
Mailing Address - Country:US
Mailing Address - Phone:412-214-0042
Mailing Address - Fax:412-385-2468
Practice Address - Street 1:5725 FORWARD AVE STE 401
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15217-2255
Practice Address - Country:US
Practice Address - Phone:412-214-0042
Practice Address - Fax:412-385-2468
Is Sole Proprietor?:No
Enumeration Date:2018-08-30
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA060048363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant