MEDICARE: DR. PETER JEFFREY CIOLEK 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
1	207YS0123X	Facial Plastic Surgery Physician	35.136448	OH
2	207Y00000X	Otolaryngology Physician	MD464209	PA

General Provider Information

NPI Number	:	1194169714
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PETER JEFFREY CIOLEK M.D.

Provider Business Mailing Address
First Line	:	9500 EUCLID AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44195-0001
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9500 EUCLID AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44195
Country	:	US
Telephone Number	:	216-444-6696
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/25/2013
Last Update Date	:	06/12/2019

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Directions to “ DR. PETER JEFFREY CIOLEK M.D.” Practice Location

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