Provider Demographics
NPI:1831279330
Name:LLENA, JOSEFINA F (MD)
Entity Type:Individual
Prefix:
First Name:JOSEFINA
Middle Name:F
Last Name:LLENA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:459 UNDERHILL AVE
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-4036
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:718-653-3409
Practice Address - Street 1:MMC - DEPT. OF PATHOLOGY
Practice Address - Street 2:111 EAST 210TH STREET, RM. 206
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467
Practice Address - Country:US
Practice Address - Phone:718-920-4446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY116485207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology