Doctor Name: | MRS. ANDREA CAROL PENA |
NPI Number: | 1033546932 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | R.T. (R) |
License Number: | 13424 |
Business Practice Address: | 12033 Agency Rd Parker, AZ - 853447718 |
Business Phone Number: | 9286693380 |
Business Fax Number: | 9286693377 |
Mailing Address: | 12033 Agency Rd, PARKER |
State: | AZ |
Postal Code: | 853447718 |
Phone Number: | 9286693380 |
Fax Number: | 9286693377 |
NPI Enumeration Date: | 10/09/2013 |
NPI Last Update Date: | 10/09/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 247100000X |
License Number: | 13424 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
Taxonomy Classification: | Radiologic Technologist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is trained and qualified in the art and science of both ionizing and non-ionizing radiation for the purposes of diagnostic medical imaging, interventional procedures and therapeutic treatment. |