Basic Information
| Provider Information | |||||||||
| NPI: | 1497270235 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PENA-VELEZ | ||||||||
| FirstName: | ANA | ||||||||
| MiddleName: | AMARILY | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | TEACHER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 222 BEDFORD PARK BLVD APT 5C | ||||||||
| Address2: | |||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104582550 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7182208627 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 535 8TH AVE FL 2 | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100184332 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2127879700 | ||||||||
| FaxNumber: | 2127874418 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/12/2017 | ||||||||
| LastUpdateDate: | 08/12/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 351967091 | NY | Y | Other Service Providers | Specialist |
No ID Information.