Provider Demographics
NPI:1972680957
Name:JOSEPH E. CENTA, M.D., LLC
Entity Type:Organization
Organization Name:JOSEPH E. CENTA, M.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:EMIL
Authorized Official - Last Name:CENTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-668-6655
Mailing Address - Street 1:278 BENEDICT AVE
Mailing Address - Street 2:SUITE 450
Mailing Address - City:NORWALK
Mailing Address - State:OH
Mailing Address - Zip Code:44857-2399
Mailing Address - Country:US
Mailing Address - Phone:419-668-6655
Mailing Address - Fax:419-663-6699
Practice Address - Street 1:278 BENEDICT AVE
Practice Address - Street 2:SUITE 450
Practice Address - City:NORWALK
Practice Address - State:OH
Practice Address - Zip Code:44857-2399
Practice Address - Country:US
Practice Address - Phone:419-668-6655
Practice Address - Fax:419-663-6699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35081040261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2347802Medicaid
OHH91372Medicare UPIN
OHCE4092401Medicare ID - Type Unspecified