Individual
CHRISTIAN DAVID PENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
63 OAKCREST AVE, MIDDLE ISLAND, NY 11953-1415
(631) 594-3800
Mailing address
84 GLEN HOLLOW DRIVE, PORT JEFFERSON STATION, NY 11776-3511
(914) 218-0040
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
012087
NY
Other
Enumeration date
12/09/2020
Last updated
05/18/2025
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