Healthcare Provider Details

I. General information

NPI: 1285418624
Provider Name (Legal Business Name): SYBIL HAPPY GODAY PENA PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2023
Last Update Date: 08/24/2023
Certification Date: 08/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 E 77TH ST # 4E
NEW YORK NY
10075-1850
US

IV. Provider business mailing address

701 W 176TH ST APT 2A
NEW YORK NY
10033-7513
US

V. Phone/Fax

Practice location:
  • Phone: 646-884-1202
  • Fax:
Mailing address:
  • Phone: 646-579-8257
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number064978
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: