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1265942007
JUSTIN DAVID PENNER
BRONX, NY
NPI
1265942007
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: NY 021644)
Enumeration Date
2017-10-06
Last Update Date
2017-10-06
Business Address
JUSTIN DAVID PENNER PhD
130 W KINGSBRIDGE RD
BRONX, NY 10468-3904
Phone number: 718-584-9000
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Mailing Address
JUSTIN DAVID PENNER PhD
130 W KINGSBRIDGE RD
BRONX, NY 10468-3904
Phone number: 718-584-9000
Copy
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