Basic Information
| Provider Information | |||||||||
| NPI: | 1477812980 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BARCIA-PENA | ||||||||
| FirstName: | PAULA | ||||||||
| MiddleName: | MARIA | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 718 TEANECK RD | ||||||||
| Address2: | HEALTH PARTNER SERVICES | ||||||||
| City: | TEANECK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 076664245 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2018333000 | ||||||||
| FaxNumber: | 2012276207 | ||||||||
| Practice Location | |||||||||
| Address1: | 222 CEDAR LANE | ||||||||
| Address2: | SUITE 207 | ||||||||
| City: | TEANECK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 076664312 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2018337087 | ||||||||
| FaxNumber: | 2018337123 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2012 | ||||||||
| LastUpdateDate: | 12/07/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 25MA09851400 | NJ | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 0520225 | 05 | NJ | MEDICAID |