| Doctor Name: | PATRICIA E PENNA |
| NPI Number: | 1215091012 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | 371523-1 |
| Business Practice Address: | 14 Tulip Grove Dr Lake Grove, NY - 117551821 |
| Business Phone Number: | 6319810704 |
| Business Fax Number: | |
| Mailing Address: | 14 Tulip Grove Dr, LAKE GROVE |
| State: | NY |
| Postal Code: | 117551821 |
| Phone Number: | 6319810704 |
| Fax Number: | |
| NPI Enumeration Date: | 12/19/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WG0000X |
| License Number: | 371523-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | General Practice |
| Taxonomy Definition: | |