Individual
MARIA RENA PENECILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
74 MADISON AVE, BERGENFIELD, NJ 07621
(718) 960-6312
(718) 960-6444
Mailing address
74 MADISON AVE, BERGENFIELD, NJ 07621-2319
(718) 960-6312
(718) 960-6444
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
440967-1
NY
Other
Enumeration date
05/29/2014
Last updated
05/29/2014
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