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General NPI Number Information
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NPI Number | 1477741593
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Entity Type | Organization
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Legal Business Name | MICHAEL T. CILETTIM.D., INC
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Dates
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Enumeration Date | 10/15/2007
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Last Update Date | 10/15/2007
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Provider Practice Location Address
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Address Line | 425 ROBBINS AVE
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City | NILES
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State | OH
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Zip | 44446-2409
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Country | US
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Telephone | 330-652-5455
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Fax | 330-652-1689
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Provider Business Mailing Address
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Address Line | 425 ROBBINS AVE
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City | NILES
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State | OH
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Zip | 44446-2409
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Country | US
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Telephone | 330-652-5455
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Fax | 330-652-1689
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL THOMAS CILETTI
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Credential | MD
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Telephone | 330-652-5455
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 35061086
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License Number State | OH
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