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General NPI Number Information
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NPI Number | 1841429859
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Entity Type | Individual
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Provider Name | ERIC C CIOE PENA MD
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Gender | Male
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Dates
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Enumeration Date | 07/11/2009
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Last Update Date | 06/18/2018
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Provider Practice Location Address
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Address Line | 622 W 168TH ST PH 1-137
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City | NEW YORK
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State | NY
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Zip | 10032
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Country | US
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Telephone | 212-305-2995
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Fax |
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Provider Business Mailing Address
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Address Line | 475 SEAVIEW AVE EMERGENCY DEPT
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City | STATEN ISLAND
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State | NY
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Zip | 10305-3436
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Country | US
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Telephone | 718-226-9158
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 258957
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License Number State | NY
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