Individual
CARLOS LENIN PENA DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SA-C
Contact information
Practice address
69 3RD AVE, PATERSON, NJ 07524-1530
(201) 450-7799
Mailing address
69 3RD AVE, PATERSON, NJ 07524-1530
(201) 450-7799
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
18-190
NY
Other
Enumeration date
04/09/2018
Last updated
04/09/2018
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