Individual
TERESA MARIE PENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
555 PAGE AVE, STATEN ISLAND, NY 10307-2033
(718) 697-3763
(718) 697-3761
Mailing address
555 PAGE AVE, STATEN ISLAND, NY 10307-2033
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
283029-1
NY
Other
Enumeration date
03/10/2012
Last updated
03/10/2012
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