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Individual
MICHAEL PENHASOV
Active
Individual
MICHAEL PENHASOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OT
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
021504-1
NY
225X00000X
Occupational Therapist
0215041
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021504-1
LICENSE#
NY
Enumeration date
05/18/2017
Last updated
09/15/2022
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