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Individual

DR. LEONARD PENACERRADA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
560 1ST AVE, NEW YORK, NY 10016-6402
(212) 434-3040
Mailing address
560 1ST AVE, NEW YORK, NY 10016-6402

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
236046
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02666228
NY
Enumeration date
09/29/2006
Last updated
03/17/2021
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