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General NPI Number Information
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NPI Number | 1861254039
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Entity Type | Individual
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Provider Name | JOSE CIJIN PUTHUSSERY MD
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Gender | Male
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Dates
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Enumeration Date | 01/24/2024
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Last Update Date | 12/24/2025
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Provider Practice Location Address
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Address Line | 4401 PENN AVE
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City | PITTSBURGH
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State | PA
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Zip | 15224-1334
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Country | US
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Telephone | 216-622-5871
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Fax |
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Provider Business Mailing Address
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Address Line | 4401 PENN AVE
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City | PITTSBURGH
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State | PA
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Zip | 15224-1334
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Country | US
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Telephone | 216-622-5871
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | MD491294
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 35.151513
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 5761578
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License Number State | ID
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