Individual
ISRAEL PENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
901 E TREMONT AVE, BRONX, NY 10460-4301
(646) 377-5367
Mailing address
23 LUCKY LN, WASHINGTONVILLE, NY 10992-1815
(646) 377-5367
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
TTC-III-07-30-2786
PR
Other
Enumeration date
03/13/2019
Last updated
03/13/2019
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