NPI 1003211590

Jennifer Pena

Practitioner Case Manager/Care Coordinator Amityville, NY

Practice location

Address: 37 John St, Amityville, NY 11701-2930
Phone: (631) 424-2900
Fax: (631) 608-1017

Registered specialties

Case Manager/Care Coordinator Primary

Other Service Providers Taxonomy 171M00000X Licence 23818 (NY)

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Registry record

NPI: 1003211590
Entity type: Individual
Sex (as registered): Female
NPI issued: 27 Oct 2014
Record last updated: 27 Oct 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.