Healthcare Provider Details

I. General information

NPI: 1629067186
Provider Name (Legal Business Name): JUAN C CELEDON M.D., DR.P.H.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2005
Last Update Date: 03/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CHILDRENS HOSPITAL DR 4401 PENN AVENUE
PITTSBURGH PA
15224-1529
US

IV. Provider business mailing address

1 CHILDRENS HOSPITAL DR 4401 PENN AVENUE
PITTSBURGH PA
15224-1529
US

V. Phone/Fax

Practice location:
  • Phone: 412-692-5661
  • Fax: 412-692-6645
Mailing address:
  • Phone: 412-692-5661
  • Fax: 412-692-6645

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number153557
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License NumberMD439985
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD439985
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberMD439985
License Number StatePA
# 5
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberMD439985
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: