Individual
MR. JACOB BURNELL PENHOLLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
116 INTERSTATE PKWY, BRADFORD, PA 16701-1036
(814) 362-8274
Mailing address
1160 CHILI AVE STE 200, ROCHESTER, NY 14624-3035
(585) 426-4990
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
351530
NY
Other
Enumeration date
10/09/2024
Last updated
10/09/2024
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