Provider Demographics
NPI:1821395005
Name:RLSCC, LLC
Entity Type:Organization
Organization Name:RLSCC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SANTIAGO
Authorized Official - Middle Name:A
Authorized Official - Last Name:CENTURION
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-836-9696
Mailing Address - Street 1:222 CEDAR LN
Mailing Address - Street 2:SUITE 303
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-4314
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:222 CEDAR LN
Practice Address - Street 2:SUITE 303
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-4314
Practice Address - Country:US
Practice Address - Phone:201-836-9696
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-23
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty