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General NPI Number Information
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NPI Number | 1659381838
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Entity Type | Individual
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Provider Name | DELBA JOSEFINA PENA DDS PC
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Gender | Female
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 186 CLINTON ST
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City | HEMPSTEAD
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State | NY
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Zip | 11550-2600
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Country | US
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Telephone | 516-483-8136
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Fax | 516-483-8134
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Provider Business Mailing Address
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Address Line | 1000 FRONT ST P.O. BOX 160
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City | UNIONDALE
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State | NY
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Zip | 11553-1638
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Country | US
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Telephone | 516-483-8134
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Fax | 516-483-8134
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 047706
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License Number State | NY
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