Individual
ELISA PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
50 BROADWAY, NEW YORK, NY 10004-1607
(212) 254-0333
Mailing address
50 BROADWAY, NEW YORK, NY 10004-1607
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
09/09/2014
Last updated
09/09/2014
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