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Dwayne Pennicooke, MSED
NPI 1538422274 · on the registry since 2012 · sole proprietor
Practice
- Address
- 4828 Osgood St
Bronx, NY 10470 - Phone
- (914) 290-9041
Registry record
- Primary taxonomy
- Specialist
174400000X
- Also registered as
- Early Intervention Provider Agency
- Licence states on file
- NY
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2012-06-18
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New York