Healthcare Provider Details

I. General information

NPI: 1497338321
Provider Name (Legal Business Name): JOSEPH P PARENTEAU
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2021
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17876 SAINT CLAIR AVE
CLEVELAND OH
44110-2602
US

IV. Provider business mailing address

17876 SAINT CLAIR AVE
CLEVELAND OH
44110-2602
US

V. Phone/Fax

Practice location:
  • Phone: 419-502-2800
  • Fax:
Mailing address:
  • Phone: 216-383-3738
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number58.031914
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number34017220
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: