Provider Demographics
NPI:1952052409
Name:CENTIA HEALTH PENNSYLVANIA PLLC
Entity Type:Organization
Organization Name:CENTIA HEALTH PENNSYLVANIA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:SOSUNMOLU
Authorized Official - Middle Name:
Authorized Official - Last Name:SHOYINKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-589-4879
Mailing Address - Street 1:36 E FRONT ST
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-2936
Mailing Address - Country:US
Mailing Address - Phone:267-702-5246
Mailing Address - Fax:610-273-5542
Practice Address - Street 1:36 E FRONT ST
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-2936
Practice Address - Country:US
Practice Address - Phone:484-301-0057
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-17
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty