Mark Eric Penn Jr.

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

634 Saint Nicholas Ave Apt 1G
New York, NY 10030-1013

Phone

(757) 918-0068

NPI assigned

Jul 16, 2019

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1563235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563235200000",
    "number": "1003468430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "634 SAINT NICHOLAS AVE APT 1G",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100301013",
            "telephone_number": "757-918-0068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "634 SAINT NICHOLAS AVE APT 1G",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100301013",
            "telephone_number": "757-918-0068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENN",
        "first_name": "MARK",
        "middle_name": "ERIC",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-16",
        "last_updated": "2019-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deahna Penn
• Elizabeth Penn, PT
• Jacqueline Penn, MD
• Lauren Ashley Penn, M.D.
• Madeline Penn, MD
• Michael R Penn, LCSW
• Stacey Michelle Penn, LMSW
• Christina M Penna
• Sara Penna, REGISTERED DIETITIAN
• Stephanie Pennacchia, LCSW

• Behavior Analyst in New York, NY
• Providers in New York, NY by specialty
• Behavior Analyst in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.