Healthcare Provider Details

I. General information

NPI: 1790613065
Provider Name (Legal Business Name): LIAM CEDENO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2026
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

431 N 21ST ST
CAMP HILL PA
17011-2202
US

IV. Provider business mailing address

431 N 21ST ST
CAMP HILL PA
17011-2202
US

V. Phone/Fax

Practice location:
  • Phone: 717-761-1038
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number1070716
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: