Provider Demographics
NPI:1356015838
Name:ARENILLAS, JOHANNA P
Entity Type:Individual
Prefix:
First Name:JOHANNA
Middle Name:P
Last Name:ARENILLAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 WESTCHESTER AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:PURCHASE
Mailing Address - State:NY
Mailing Address - Zip Code:10577-2554
Mailing Address - Country:US
Mailing Address - Phone:914-328-2868
Mailing Address - Fax:
Practice Address - Street 1:2700 WESTCHESTER AVE STE 300
Practice Address - Street 2:
Practice Address - City:PURCHASE
Practice Address - State:NY
Practice Address - Zip Code:10577-2554
Practice Address - Country:US
Practice Address - Phone:914-328-2868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-06
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No252Y00000XAgenciesEarly Intervention Provider Agency