# MICHELLE GUEVARRA PENA PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Michelle Guevarra-Pena MD
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518923598
- **Authorized official:** DR. MICHELLE GUEVARRA-PENA MD (SOLE MEMBER)
- **Authorized official phone:** (631) 475-0222

## Contact information

- **Practice address:** 14-A JAYNE AVENUE, PATCHOGUE, NY 11772
- **Practice address phone:** (631) 475-0222
- **Practice address fax:** (631) 475-4586
- **Mailing address:** 14-A JAYNE AVENUE, PATCHOGUE, NY 11772
- **Mailing address phone:** (631) 475-0222
- **Mailing address fax:** (631) 475-4586

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/26/2006
- **Last updated:** 08/22/2020