Penza, Frederick W.

Penza, Frederick W. is an sole proprietor health care provider with primary practice located at 6 Enfield Dr , Andover MA 01810-6021. He recently has only one registered license in Behavioral Health & Social Service Providers / Health Service, which is considered as his primary health care specialty. Penza, Frederick W. can be contacted via phone (978) 475-6169.

Contact Information

Primary practice address
6 Enfield Dr Andover MA 01810-6021
Phone: (978) 475-6169
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Health Service 103TH0100X 871 Massachusetts

Profile Details

NPI number 1720143381
LBN Legal business name Penza, Frederick W.
Credentials ED.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 26th, 2006
Last updated Jul 9th, 2007 - about 17 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 1720143381 NPPES
Massachusetts MEDICAID 0505366
Massachusetts Other WO1265

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