Individual
DIEGO ALFONSO PENA-MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
457 W 57TH ST APT 207, NEW YORK, NY 10019-1701
(787) 317-9276
Mailing address
457 W 57TH ST APT 207, NEW YORK, NY 10019-1701
(787) 317-9276
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
12/05/2024
Last updated
12/05/2024
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