Provider Demographics
NPI:1013463686
Name:CENTURIONI, CHELSEA LEIGH (PA-C)
Entity type:Individual
Prefix:MRS
First Name:CHELSEA
Middle Name:LEIGH
Last Name:CENTURIONI
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:124 ROSA ROAD
Mailing Address - Street 2:SUITE 382
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12308
Mailing Address - Country:US
Mailing Address - Phone:518-386-3691
Mailing Address - Fax:518-386-3553
Practice Address - Street 1:124 ROSA ROAD
Practice Address - Street 2:SUITE 382
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12308
Practice Address - Country:US
Practice Address - Phone:518-386-3691
Practice Address - Fax:518-386-3553
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2023-02-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY020381363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY4622482Medicaid