Ely Pena, MS

Primary specialty

SpecialistTaxonomy code 174400000X

License

2594179 Issued in NY

Practice address

11835 Farmers Blvd Apt 106
Saint Albans, NY 11412-4004

Phone

(917) 272-2014

NPI assigned

Feb 18, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Maria Elisabeht Pena Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1613606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613606400000",
    "number": "1710570916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11835 FARMERS BLVD APT 106",
            "city": "SAINT ALBANS",
            "state": "NY",
            "postal_code": "114124004",
            "telephone_number": "917-272-2014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11835 FARMERS BLVD APT 106",
            "city": "SAINT ALBANS",
            "state": "NY",
            "postal_code": "114124004",
            "telephone_number": "917-272-2014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA",
        "first_name": "ELY",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-18",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "2594179",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "550493040",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER LICENSE",
            "identifier": "127-572-899",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER LICENSE",
            "identifier": "127572899",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Queens",
            "affiliation": "N",
            "endpointDescription": "ABA tharapy",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Bronx",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Brooklyn",
            "address_1": "11835 Farmers Blvd Apt 106",
            "city": "Saint Albans",
            "state": "NY",
            "country_code": "US",
            "postal_code": "114124004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARIA",
            "last_name": "PENA",
            "middle_name": "ELISABEHT",
            "credential": "MS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cregy Patterson, NURSE PRACTITIONER
• Felicia Michele Paul
• Latanya Pearson
• Ashleigh Pegg
• Lydie Pelissier, RN
• Lys Claudie Perard
• Ann Pereira
• Natasha Yvrose Petit
• Pharmacy World Inc.
• Nadine S Phillips-Paterson, RN, BSN, MSN

• Specialist in Saint Albans, NY
• Providers in Saint Albans, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 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.