Individual
MR. ALEXANDER JOSEPH PENNISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
715 9TH AVE, NEW YORK, NY 10019
(212) 757-3859
Mailing address
417 E 74TH ST APT 17, NEW YORK, NY 10021-3950
(585) 831-7672
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
025458
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
NY
Other
Enumeration date
05/08/2020
Last updated
03/13/2024
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