Individual
CHRISTINE MARIE PENICKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, PA-C
Contact information
Practice address
391 MYRTLE AVE STE 3A, ALBANY, NY 12208-3797
(518) 262-5588
Mailing address
391 MYRTLE AVE STE 3A, ALBANY, NY 12208-3797
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
86101200
—
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
10/02/2018
Last updated
06/15/2022
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