Robert Vincent Pena Diaz, MS.ED

Primary specialty

SpecialistTaxonomy code 174400000X

Practice address

3915 62ND St Apt 42
Woodside, NY 11377-3612

Phone

(347) 585-6005

NPI assigned

Apr 22, 2014

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1398124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1912327677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4032 77TH ST FL 3",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731151",
            "telephone_number": "347-585-6005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3915 62ND ST APT 42",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113773612",
            "telephone_number": "347-585-6005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA DIAZ",
        "first_name": "ROBERT",
        "middle_name": "VINCENT",
        "name_prefix": "Mr.",
        "credential": "MS.ED",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-22",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pearle Vision Inc (Pearle Vision #C6508)
• Priska Pedernera, LMSW
• Aris Rafael Peguero
• Kumari Hope Peiris
• Alexandra Pelaez, LMFT
• Crystal Pena, PTA
• Melissa Pena
• Khea Mel Estorninos Perales, PTA
• Peralta Primary Care P.C.
• Marina C Peralta, BSN, RN, CCTN

• Specialist in Woodside, NY
• Providers in Woodside, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.