Most Relevant Information
Provider Data
| NPI Number: | 1003468430 |
| Provider Name: | MARK ERIC PENN |
| Entity Type: | Individual |
| Taxonomy Code: | 103K00000X |
| Specialty: | Behavior Analyst |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/16/2019 |
| Last Updated: | 07/16/2019 |
Provider Practice Location
634 SAINT NICHOLAS AVE APT 1G
NEW YORK
NY
100301013
Practice Location Phone/Fax
| Phone: | 7579180068 |
| Fax: |
Provider Mailing Location
634 SAINT NICHOLAS AVE APT 1G
NEW YORK
NY
100301013
Provider Mailing Phone/Fax
| Phone: | 7579180068 |
| Fax: |