Individual
JENNIFER PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
37 JOHN ST, AMITYVILLE, NY 11701-2930
(631) 424-2900
(631) 608-1017
Mailing address
37 JOHN ST, AMITYVILLE, NY 11701-2930
(631) 424-2900
(631) 608-1017
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
23818
NY
Other
Enumeration date
10/27/2014
Last updated
10/27/2014
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