Active NPI
Donna Patricia Penn, M.ED., TSHH
- Behavior Analyst
- Bayside, NY
National Provider Identifier
1467769836
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 400912031
- Practice address
- 20411 45TH Dr
Bayside, NY 11361-3114 - Phone
- (347) 683-3319
- NPI assigned
- Sep 8, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 400912031 | NY | Primary |
Addresses
Primary practice location
20411 45TH Dr
Bayside, NY 11361-3114
Mailing address
20411 45TH Dr
Bayside, NY 11361-3114
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
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 400912031 | NY | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1283904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1460592000000",
"number": "1467769836",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20411 45TH DR",
"city": "BAYSIDE",
"state": "NY",
"postal_code": "113613114"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20411 45TH DR",
"city": "BAYSIDE",
"state": "NY",
"postal_code": "113613114",
"telephone_number": "347-683-3319"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENN",
"first_name": "DONNA",
"middle_name": "PATRICIA",
"name_prefix": "Ms.",
"credential": "M.ED., TSHH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-09-08",
"last_updated": "2016-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "NY",
"license": "400912031",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bayside, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.