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NPI Code Detail

MEDICARE: CEENA PHILIPOSE PAUL M.D.

MEDICARE: CEENA PHILIPOSE PAUL M.D.
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
1208000000XPediatrics Physician35.128797OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1043573876
Entity Type Code : Individual
Provider Name (Legal Business Name) : CEENA PHILIPOSE PAUL M.D.
Provider Business Mailing Address
First Line : PO BOX 933432
Second Line :
City : CLEVELAND
State : OH
Zip : 44193-0039
Country : US
Telephone Number : 937-641-5072
Fax Number : 937-641-6129
Provider Business Practice Location Address
First Line : 204 PATRICK AVE
Second Line :
City : URBANA
State : OH
Zip : 43078-2302
Country : US
Telephone Number : 937-484-6157
Fax Number : 937-484-6181
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2012
Last Update Date : 01/21/2026

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