Provider Demographics
NPI:1629067186
Name:CELEDON, JUAN C (MD, DRPH)
Entity Type:Individual
Prefix:DR
First Name:JUAN
Middle Name:C
Last Name:CELEDON
Suffix:
Gender:M
Credentials:MD, DRPH
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Mailing Address - Street 1:1 CHILDRENS HOSPITAL DR
Mailing Address - Street 2:4401 PENN AVENUE
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15224-1529
Mailing Address - Country:US
Mailing Address - Phone:412-692-5661
Mailing Address - Fax:412-692-6645
Practice Address - Street 1:1 CHILDRENS HOSPITAL DR
Practice Address - Street 2:4401 PENN AVENUE
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-1529
Practice Address - Country:US
Practice Address - Phone:412-692-5661
Practice Address - Fax:412-692-6645
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2013-03-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA153557207RP1001X
PAMD4399852080P0214X, 207R00000X, 207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA184193Medicare PIN