Individual provider · Type 1 NPI
Dwayne A. Pennicooke, MSED
Specialist · Bronx, NY
NPI number
1538422274
Active
Practice location
4828 Osgood St
Bronx, NY 10470-1021
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Specialist Primary | 174400000X | 811870 (NY) |
| Early Intervention Provider Agency | 252Y00000X | None listed |
Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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About NPI 1538422274
Dwayne A. Pennicooke, MSED's National Provider Identifier is 1538422274, issued on Jun 18, 2012. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Bronx, NY. The record was last updated on Jun 18, 2012.