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General NPI Number Information
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NPI Number | 1851827802
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Entity Type | Organization
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Legal Business Name | CENTURION ANESTHESIA OF NEW JERSEY INC
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Dates
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Enumeration Date | 05/11/2017
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Last Update Date | 05/11/2017
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Provider Practice Location Address
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Address Line | 200 CLIFTON BLVD
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City | CLIFTON
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State | NJ
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Zip | 07011-3652
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Country | US
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Telephone | 718-222-5999
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Fax | 718-387-6429
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Provider Business Mailing Address
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Address Line | 181 E 73RD ST 20A
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City | NEW YORK
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State | NY
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Zip | 10021-3549
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Country | US
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Telephone | 718-222-5999
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Fax | 718-387-6429
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | LEONID ROSIN
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Credential | MD
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Telephone | 718-222-5999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 25MA07231300
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License Number State | NJ
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