Individual provider Active NPI

Marielle Nicole Penyy, DVM

  • Veterinarian
  • New Hyde Park, NY
National Provider Identifier
1417291303
Registry record updated Mar 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
VeterinarianTaxonomy code 174M00000X
License
012104 Issued in NY
Practice address
2221 Hillside Ave
New Hyde Park, NY 11040-2714
Phone
(516) 877-2287
Fax
(516) 877-2281
NPI assigned
Nov 16, 2012
Last updated
Mar 7, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Veterinarian 174M00000X 012104 NY Primary

Addresses

Primary practice location

2221 Hillside Ave
New Hyde Park, NY 11040-2714

Mailing address

2221 Hillside Ave
New Hyde Park, NY 11040-2714
Phone (516) 877-2287

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
012104NYMDVeterinarian

NPI Registry JSON

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

{
    "created_epoch": "1353024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772841600000",
    "number": "1417291303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2221 HILLSIDE AVE",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110402714",
            "telephone_number": "516-877-2287",
            "fax_number": "516-877-2281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2221 HILLSIDE AVE",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110402714",
            "telephone_number": "516-877-2287",
            "fax_number": "516-877-2281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENYY",
        "first_name": "MARIELLE",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "DVM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-16",
        "last_updated": "2026-03-07",
        "certification_date": "2026-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174M00000X",
            "taxonomy_group": "",
            "desc": "Veterinarian",
            "state": "NY",
            "license": "012104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2026; 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.