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General NPI Number Information
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NPI Number | 1336196435
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Entity Type | Individual
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Provider Name | JESSICA PENA M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/27/2006
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Last Update Date | 08/14/2023
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Provider Practice Location Address
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Address Line | 1825 EASTCHESTER RD CARDIOLOGY ADMINISTRATION
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City | BRONX
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State | NY
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Zip | 10461-2301
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Country | US
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Telephone | 718-904-3388
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Fax |
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Provider Business Mailing Address
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Address Line | 428 E 72ND ST OFC 300
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City | NEW YORK
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State | NY
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Zip | 10021-4635
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Country | US
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Telephone | 646-962-4278
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 236425
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 236425
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License Number State | NY
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