Ali-Pennock, Vanessa Ambereen

Ali-Pennock, Vanessa Ambereen is an individual health care provider with primary practice located at 54 Sunnyside Blvd , Plainview NY 11803-1517. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Ali-Pennock, Vanessa Ambereen can be contacted via phone (516) 506-7776.

Contact Information

Primary practice address
54 Sunnyside Blvd Plainview NY 11803-1517
Phone: (516) 506-7776
Fax: (516) 719-0708
Website:
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Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 260126 New York

Profile Details

NPI number 1205066503
LBN Legal business name Ali-Pennock, Vanessa Ambereen
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 21st, 2009
Last updated Feb 26th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205066503 NPPES
New York MEDICAID 3545622

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