Deyanira Pena-Placencia, INDEPENDENT CONTRACT

Primary specialty

Blood BankTaxonomy code 331L00000X

Practice address

4 Monroe St # 2a
Passaic, NJ 07055-8108

Phone

(973) 405-8595

Fax

(973) 779-4804

NPI assigned

Apr 5, 2021

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ubersticks Medical LLC

  • Clinical Medical Laboratory
  • Passaic, NJ
  • NPI 1528636594
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1617580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617580800000",
    "number": "1346829579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 MONROE ST",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070558108",
            "telephone_number": "973-405-8595",
            "fax_number": "973-779-4804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 MONROE ST # 2A",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070558108",
            "telephone_number": "973-405-8595",
            "fax_number": "973-779-4804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA-PLACENCIA",
        "first_name": "DEYANIRA",
        "credential": "INDEPENDENT CONTRACT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-05",
        "last_updated": "2021-04-05",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "331L00000X",
            "taxonomy_group": "",
            "desc": "Blood Bank",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INSURANCE STATUS PENDING",
            "identifier": "NG",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marisa Patrisso, LAC
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• Blood Bank in Passaic, NJ
• Providers in Passaic, NJ by specialty
• Blood Bank in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.