Provider Demographics
NPI:1841539657
Name:YPP NEW MODERN MEDICINE PLLC
Entity type:Organization
Organization Name:YPP NEW MODERN MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:YOMARIS
Authorized Official - Middle Name:MERCEDES
Authorized Official - Last Name:PENA PENA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:347-375-3774
Mailing Address - Street 1:330 W 45TH ST
Mailing Address - Street 2:APT 1H
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-3853
Mailing Address - Country:US
Mailing Address - Phone:646-595-9063
Mailing Address - Fax:
Practice Address - Street 1:201 WADSWORTH AVE
Practice Address - Street 2:UNIT GD3
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-3862
Practice Address - Country:US
Practice Address - Phone:347-375-3774
Practice Address - Fax:212-567-0459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-14
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty