Active NPI
Ysalia Lidorca Pena, LMSW
- Social Worker
- Bronx, NY
National Provider Identifier
1992579007
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 114418-01
- Practice address
- 6214 Riverdale Ave Ste 1a
Bronx, NY 10471-1032 - Phone
- (718) 701-4807
- NPI assigned
- Nov 9, 2023
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 114418-01 | NY | Primary |
Addresses
Primary practice location
6214 Riverdale Ave Ste 1a
Bronx, NY 10471-1032
Mailing address
772 Elsmere PL
Bronx, NY 10460-4103
Phone (917) 407-3762
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 114418-01 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1699488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699488000000",
"number": "1992579007",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "772 ELSMERE PL",
"city": "BRONX",
"state": "NY",
"postal_code": "104604103",
"telephone_number": "917-407-3762"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6214 RIVERDALE AVE STE 1A",
"city": "BRONX",
"state": "NY",
"postal_code": "104711032",
"telephone_number": "718-701-4807"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENA",
"first_name": "YSALIA",
"middle_name": "LIDORCA",
"name_prefix": "Mrs.",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-11-09",
"last_updated": "2023-11-09",
"certification_date": "2023-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "114418-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.