Mr. Dwayne A Pennicooke, MSED
Mr. Dwayne A Pennicooke, MSED is a Specialist in Bronx, New York. Practices as a sole proprietor. Licensed in New York.
- Licensed in
- NY
- In the registry since
- 2012
- Specialties on file
- 2
Practice location Address checks out
4828 Osgood StBronx, NY 10470-1021
Phone: (914) 290-9041
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Specialties & licences
| Specialist (primary) | Taxonomy 174400000X · Licence 811870 (NY) |
|---|---|
| Early Intervention Provider Agency | Taxonomy 252Y00000X |
Record details
| NPI number | 1538422274 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | MSED |
| Sole proprietor | Yes |
| NPI enumerated | June 18, 2012 |
| Last updated in NPPES | June 18, 2012 |
| Mailing address | 4828 Osgood St, Bronx, NY 10470-1021 |
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