Individual
EVELYN PENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
201 LYONS AVE, FAMILY TREATMENT CENTER G-3, NEWARK, NJ 07112-2027
(973) 926-6925
Mailing address
201 LYONS AVE, FAMILY TREATMENT CENTER G-3, NEWARK, NJ 07112-2027
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
839523
NJ
Other
Enumeration date
12/18/2006
Last updated
07/08/2007
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