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NPI Code Detail

MEDICARE: CAITLIN CEGLAREK

MEDICARE: CAITLIN CEGLAREK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
150.005433RXOTHEROHMEDICAL LICENSE

General Provider Information

NPI Number : 1457851602
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAITLIN CEGLAREK
Provider Business Mailing Address
First Line : 2865 N REYNOLDS RD BLDG A
Second Line :
City : TOLEDO
State : OH
Zip : 43615-2100
Country : US
Telephone Number : 419-578-7200
Fax Number :
Provider Business Practice Location Address
First Line : 2865 N REYNOLDS RD BLDG A
Second Line :
City : TOLEDO
State : OH
Zip : 43615-2100
Country : US
Telephone Number : 419-578-7200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2018
Last Update Date : 11/03/2023

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Directions to “ CAITLIN CEGLAREK ” Practice Location

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