Healthcare Provider Details

I. General information

NPI: 1962030981
Provider Name (Legal Business Name): LEON ERNEST CEDENO DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: LEON ERNEST CEDENO DO

II. Dates (important events)

Enumeration Date: 03/27/2020
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 ST LUKES LN
STROUDSBURG PA
18360-6217
US

IV. Provider business mailing address

100 ST LUKES LN
STROUDSBURG PA
18360-6217
US

V. Phone/Fax

Practice location:
  • Phone: 973-902-8972
  • Fax:
Mailing address:
  • Phone: 973-902-8972
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberOS025655
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: