Provider Demographics
NPI:1427395557
Name:PENA, YRINA YAMILKA
Entity Type:Individual
Prefix:
First Name:YRINA
Middle Name:YAMILKA
Last Name:PENA
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 1:61 HAMILTON PL
Mailing Address - Street 2:APT 42
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10031-6840
Mailing Address - Country:US
Mailing Address - Phone:347-604-3859
Mailing Address - Fax:
Practice Address - Street 1:61 HAMILTON PL
Practice Address - Street 2:APT 42
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10031-6840
Practice Address - Country:US
Practice Address - Phone:347-604-3859
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-09
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator