Individual
MS. RENEE EVA PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
22C W 34TH ST, BAYONNE, NJ 07002-8688
(917) 755-3572
Mailing address
22C W 34TH ST, BAYONNE, NJ 07002-8688
(917) 755-3572
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
712779131
NY
Other
Enumeration date
03/05/2013
Last updated
03/05/2013
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