Individual
CRYSTAL PENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
4277 65TH PL, WOODSIDE, NY 11377-5054
(718) 429-2000
Mailing address
3338 72ND ST, JACKSON HEIGHTS, NY 11372-1042
(347) 939-9539
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
011023
NY
Other
Enumeration date
05/02/2019
Last updated
05/02/2019
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