Individual
DR. MARIANGELA PENNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
209-19 34TH ROAD, BAYSIDE, NY 11361
(718) 423-6762
(718) 423-6762
Mailing address
209-19 34TH ROAD, BAYSIDE, NY 11361
(718) 423-6762
(718) 423-6762
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X004855
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C048555
WORKERS COMPENSATION
NY
Enumeration date
04/18/2006
Last updated
12/28/2009
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