Individual
JOHN PERCIVAL PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ANP-BC, GNP, RN-BSN
Contact information
Practice address
1 GUSTAVE L LEVY PL, NEW YORK, NY 10029-6500
(212) 241-6500
Mailing address
175 E 93RD ST APT 2D, NEW YORK, NY 10128-3980
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F306047-1
NY
363LG0600X
Gerontology Nurse Practitioner
F340844-1
NY
Other
Enumeration date
01/23/2013
Last updated
01/23/2013
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