| Centia Health Pennsylvania Pllc | |
|
36 E Front St Media PA 19063-2936 | |
| (484) 301-0057 | |
| Not Available |
| Full Name | Centia Health Pennsylvania Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 36 E Front St, Media, Pennsylvania |
| Authorized Official Name and Position | Sosunmolu Shoyinka (MD) |
| Authorized Official Contact | 9175894879 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Centia Health Pennsylvania Pllc 36 E Front St Media PA 19063-2936 Ph: (267) 702-5246 | Centia Health Pennsylvania Pllc 36 E Front St Media PA 19063-2936 Ph: (484) 301-0057 |
| NPI Number | 1952052409 |
|---|---|
| Provider Enumeration Date | 01/17/2022 |
| Last Update Date | 09/19/2023 |
| Certification Date | 09/19/2023 |
| Medicare PECOS PAC ID | 7517353329 |
|---|---|
| Medicare Enrollment ID | O20220404002412 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952052409 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Sosunmolu Opememi Shoyinka |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811181696 PECOS PAC ID: 4385760461 Enrollment ID: I20200207000261 |
| Provider Name | Charlotte Nwogwugwu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982357034 PECOS PAC ID: 3274994611 Enrollment ID: I20231220000858 |
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