Provider Demographics
NPI:1962030981
Name:CEDENO, LEON ERNEST
Entity Type:Individual
Prefix:
First Name:LEON
Middle Name:ERNEST
Last Name:CEDENO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:LEON
Other - Middle Name:ERNEST
Other - Last Name:CEDENO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:54 GOLF RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-3119
Mailing Address - Country:US
Mailing Address - Phone:973-902-8972
Mailing Address - Fax:
Practice Address - Street 1:703 MAIN ST
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07503-2621
Practice Address - Country:US
Practice Address - Phone:973-754-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-27
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program