Provider Demographics
NPI:1669259602
Name:PENDRAGON, PIX REX (RN)
Entity type:Individual
Prefix:MR
First Name:PIX
Middle Name:REX
Last Name:PENDRAGON
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:DIGNA
Other - Last Name:YUDLOWITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:145 E 32ND ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-6066
Mailing Address - Country:US
Mailing Address - Phone:212-779-9207
Mailing Address - Fax:
Practice Address - Street 1:145 E 32ND ST FL 6
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6055
Practice Address - Country:US
Practice Address - Phone:212-779-9207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-13
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY677332163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult