Individual
DR. JUAN PABLO PENALOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1276 FULTON AVE, BRONX, NY 10456-3402
(718) 901-8484
(718) 901-8656
Mailing address
1276 FULTON AVE, BRONX, NY 10456-3402
(718) 901-8484
(718) 901-8656
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
262670
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/20/2008
Last updated
11/12/2013
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