Individual
YOLANDA M PENA
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
40 DALE RD, STE 104, AVON, CT 06001-3692
(860) 676-8115
(860) 677-6015
Mailing address
40 DALE RD, SUITE 200, AVON, CT 06001-3692
(860) 676-8115
(860) 677-6015
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
023674
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001236744
—
CT
01
—
010023674CT02
ANTHEM BCBS
CT
01
—
0V0022
HEALTHNET
CT
Enumeration date
03/01/2006
Last updated
08/31/2016
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