Pennicooke, Dwayne A

Pennicooke, Dwayne A is an sole proprietor health care provider with primary practice located at 4828 Osgood St , Bronx NY 10470-1021. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Agencies / Early Intervention Provider Agency. Other Service Providers / Specialist is his primary health care specialty. Pennicooke, Dwayne A can be contacted via phone (914) 290-9041.

Contact Information

Primary practice address
4828 Osgood St Bronx NY 10470-1021
Phone: (914) 290-9041
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 811870 New York
Agencies / Early Intervention Provider Agency 252Y00000X

Profile Details

NPI number 1538422274
LBN Legal business name Pennicooke, Dwayne A
Credentials MSED
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 18th, 2012
Last updated Jun 18th, 2012 - about 14 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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