Individual
BERNADETTE PENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
622 W 168TH ST, NEW YORK, NY 10032-3720
Mailing address
161 FORT WASHINGTON AVE, NEW YORK, NY 10032-3729
(914) 434-8668
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
306797
NY
Other
Enumeration date
08/03/2024
Last updated
11/04/2024
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