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General NPI Number Information
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NPI Number | 1649241464
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Entity Type | Individual
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Provider Name | KATHERINE PENA MD
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Gender | Female
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Dates
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Enumeration Date | 01/30/2006
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Last Update Date | 09/03/2015
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Provider Practice Location Address
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Address Line | 269 CHATHAM RD
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City | HARWICH
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State | MA
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Zip | 02645-3309
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Country | US
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Telephone | 508-432-1400
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Fax | 508-430-2333
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Provider Business Mailing Address
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Address Line | PO BOX 1413
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City | WELLFLEET
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State | MA
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Zip | 02667-1413
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Country | US
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Telephone | 508-905-2800
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Fax | 508-240-1244
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 82127
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License Number State | MA
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