Provider Demographics
NPI:1891058244
Name:CENTENO-SOSA, ARICIA
Entity Type:Individual
Prefix:
First Name:ARICIA
Middle Name:
Last Name:CENTENO-SOSA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 PHELPS AVE
Mailing Address - Street 2:
Mailing Address - City:BERGENFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07621-1309
Mailing Address - Country:US
Mailing Address - Phone:646-489-6556
Mailing Address - Fax:
Practice Address - Street 1:45 PHELPS AVE
Practice Address - Street 2:
Practice Address - City:BERGENFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07621-1309
Practice Address - Country:US
Practice Address - Phone:646-489-6556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-20
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist