Individual
DEYANIRA PENA-PLACENCIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
INDEPENDENT CONTRACT
Contact information
Practice address
4 MONROE ST # 2A, PASSAIC, NJ 07055-8108
(973) 405-8595
(973) 779-4804
Mailing address
4 MONROE ST, PASSAIC, NJ 07055-8108
(973) 405-8595
(973) 779-4804
Taxonomy
Speciality
Code
Description
License number
State
331L00000X
Blood Bank
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NG
INSURANCE STATUS PENDING
—
Enumeration date
04/05/2021
Last updated
04/05/2021
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