Organization
DOORLAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YAMILKA PENA (PRESIDENT)
(973) 757-4153
Entity
Organization
Contact information
Practice address
67 S GLEN RD, KINNELON, NJ 07405-2715
(973) 757-4153
Mailing address
67 S GLEN RD, KINNELON, NJ 07405-2715
(973) 757-4153
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
347C00000X
Private Vehicle
—
—
Other
Enumeration date
02/01/2022
Last updated
02/07/2022
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