Healthcare Provider Details

I. General information

NPI: 1548116148
Provider Name (Legal Business Name): VANESSA TORRES PENA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2026
Last Update Date: 03/06/2026
Certification Date: 03/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5901 PALISADE AVE
BRONX NY
10471-1205
US

IV. Provider business mailing address

1034 CLINTON ST APT 110
HOBOKEN NJ
07030-3166
US

V. Phone/Fax

Practice location:
  • Phone: 551-256-1215
  • Fax:
Mailing address:
  • Phone: 551-256-1215
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number010984
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: