Individual
DOMINGO PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1150 WEBSTER AVE, BRONX, NY 10456-5205
(718) 975-1044
(917) 471-8032
Mailing address
80 HAVEN AVE APT 1A, NEW YORK, NY 10032-2615
(718) 501-2689
(917) 471-8032
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
319216
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/22/2019
Last updated
04/10/2023
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