National Provider Identifier

Kevin Mark Penner, OTR/L

Kevin Mark Penner, OTR/L is listed in the NPPES registry with a primary specialty of Specialist in Newark, NY and a listed phone number of (131) 554-8663.

NPI 1164703765Newark, NYSpecialist

Profile Overview

NPI
1164703765
Provider Type
Individual
Primary Specialty
Specialist
Enumeration Date
September 09, 2011
Last Updated
September 09, 2011

Practice Location

  • 131 Drumlin Ct
  • Newark, NY 14513-1863

Phone: (131) 554-8663

Specialties

  • Specialist (174400000X)
Full Record
NPI
1164703765
Entity Type
Individual
Last Name
Penner
First Name
Kevin
Middle Name
Mark
Name Prefix
Mr.
Credential
OTR/L
Mailing Street Address
131 Drumlin Ct
Mailing City
Newark
Mailing State
NY
Mailing ZIP Code
14513-1863
Mailing Country
US
Mailing Phone
(131) 554-8663
Practice Street Address
131 Drumlin Ct
Practice City
Newark
Practice State
NY
Practice ZIP Code
14513-1863
Practice Country
US
Practice Phone
(131) 554-8663
Enumeration Date
September 09, 2011
Last Updated
September 09, 2011
Sex
Male
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Specialist (174400000X)