Individual
PEDRO PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
201 STATE ST, ERIE, PA 16550-0002
(814) 877-6182
(814) 877-6149
Mailing address
201 STATE ST, ERIE, PA 16550-0002
(814) 877-6182
(814) 877-6149
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
MD015257E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00025445602
UNIVERA
NY
05
—
0018379020003
—
PA
01
—
02146761
NY MEDICAL ASSISTANCE
NY
01
—
1068921
W. VIRGINIA WORKERS COMP
WV
01
—
118180
UNISON
PA
01
—
1521688
GATEWAY
PA
01
—
2231365
OH MEDICAL ASSISTANCE
OH
01
—
300120916
RR MEDICARE
PA
01
—
304576
UPMC
PA
01
—
3369068
AETNA
PA
01
—
722913
BLUE SHIELD
PA
Enumeration date
07/19/2005
Last updated
05/16/2013
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