Pena, Elpidio Dejesus

Pena, Elpidio Dejesus is an individual health care provider with primary practice located at 2307 Greene Way , Louisville KY 40220-4009. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cytopathology, Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology. Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology is his primary health care specialty. Pena, Elpidio Dejesus can be contacted via phone (502) 897-9594.

Contact Information

Primary practice address
2307 Greene Way Louisville KY 40220-4009
Phone: (502) 897-9594
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cytopathology 207ZC0500X 36832 Kentucky
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 36832 Kentucky

Profile Details

NPI number 1700841152
LBN Legal business name Pena, Elpidio Dejesus
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 19th, 2006
Last updated Jun 26th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700841152 NPPES
Kentucky MEDICAID 64039423

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