MEDICARE: AIREEN CENTENO DELA PENA PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	P9998	NC

General Provider Information

NPI Number	:	1508258872
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AIREEN CENTENO DELA PENA PT

Provider Business Mailing Address
First Line	:	3420 WAKE FOREST RD
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27703-3522
Country	:	US
Telephone Number	:	919-596-9464
Fax Number	:

Provider Business Practice Location Address
First Line	:	3420 WAKE FOREST RD
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27703-3522
Country	:	US
Telephone Number	:	919-596-9464
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/24/2015
Last Update Date	:	02/24/2015

Similar Medicare Providers

1770441685 — ELIZABETH LAJOY PROCTER
Practice Location Address:

3420 WAKE FOREST RD
DURHAM, NC
27703-3522

Practice Phone: 772-618-0605
Practice Fax:

1417152109 — SUSAN JOHNSON PTA
Practice Location Address:

3420 HOLLOWAY ST
DURHAM, NC
27703-3522

Practice Phone: 919-596-9464
Practice Fax:

1629468889 — JILL HALL
Practice Location Address:

3420 WAKE FOREST RD
DURHAM, NC
27703-3522

Practice Phone: 919-596-9464
Practice Fax:

1174997233 — LEGACY HEALTHCARE SERVICES, INC
Practice Location Address:

3420 WAKE FOREST RD
DURHAM, NC
27703-3522

Practice Phone: 919-957-8480
Practice Fax: 919-957-8420

1689122178 — MR. ERIC RENSHAW PTA
Practice Location Address:

3420 HOLLOWAY ST
DURHAM, NC
27703-3522

Practice Phone: 919-596-9464
Practice Fax:

1265974075 — RUCHA SHAH
Practice Location Address:

3420 HOLLOWAY ST
DURHAM, NC
27703-3522

Practice Phone: 919-596-9464
Practice Fax:

Directions to “ AIREEN CENTENO DELA PENA PT” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.