Provider Demographics
NPI:1528753126
Name:CENSON LLC
Entity type:Organization
Organization Name:CENSON LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SIMON
Authorized Official - Middle Name:
Authorized Official - Last Name:HALLIDAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-278-9811
Mailing Address - Street 1:128 RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:VA
Mailing Address - Zip Code:22952-2811
Mailing Address - Country:US
Mailing Address - Phone:307-278-9811
Mailing Address - Fax:
Practice Address - Street 1:300 W 41ST ST STE 100
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-3627
Practice Address - Country:US
Practice Address - Phone:877-999-9563
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-10
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic SurgeryGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty