Active NPI
Dyniker Pena
- Counselor
- Roxbury, MA
National Provider Identifier
1447573951
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 30 Dimock St
Roxbury, MA 02119-1210 - Phone
- (617) 989-2860
- Fax
- (617) 445-9147
- NPI assigned
- Mar 11, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
30 Dimock St
Roxbury, MA 02119-1210
Mailing address
30 Dimock St
Roxbury, MA 02119-1210
Phone (617) 989-2860
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1268265600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328745600000",
"number": "1447573951",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 DIMOCK ST",
"city": "ROXBURY",
"state": "MA",
"postal_code": "021191210",
"telephone_number": "617-989-2860",
"fax_number": "617-445-9147"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 DIMOCK ST",
"city": "ROXBURY",
"state": "MA",
"postal_code": "021191210",
"telephone_number": "617-989-2860",
"fax_number": "617-445-9147"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENA",
"first_name": "DYNIKER",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-03-11",
"last_updated": "2012-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roxbury, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.