Provider Demographics
NPI:1851827802
Name:CENTURION ANESTHESIA OF NEW JERSEY INC
Entity Type:Organization
Organization Name:CENTURION ANESTHESIA OF NEW JERSEY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:LEONID
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-222-5999
Mailing Address - Street 1:181 E 73RD ST
Mailing Address - Street 2:20A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-3549
Mailing Address - Country:US
Mailing Address - Phone:718-222-5999
Mailing Address - Fax:718-387-6429
Practice Address - Street 1:200 CLIFTON BLVD
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07011-3652
Practice Address - Country:US
Practice Address - Phone:718-222-5999
Practice Address - Fax:718-387-6429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07231300207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty