Gregory Penczek, MS, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

A0000071 Issued in MD

Practice address

8000 York Rd
Field House 101
Towson, MD 21252-0001

Phone

(410) 704-2890

Fax

(410) 704-2727

NPI assigned

Mar 10, 2014

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

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1394409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394409600000",
    "number": "1689090029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8000 YORK RD",
            "address_2": "FIELD HOUSE 101",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212520001",
            "telephone_number": "410-704-2890",
            "fax_number": "410-704-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8000 YORK RD",
            "address_2": "FIELD HOUSE 101",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212520001",
            "telephone_number": "410-704-2890",
            "fax_number": "410-704-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENCZEK",
        "first_name": "GREGORY",
        "credential": "MS, LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-03-10",
        "last_updated": "2014-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MD",
            "license": "A0000071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jill Elizabeth Peek, PSY.D.
• Robert Fielding Pegues, M.D.
• Christina Yeager Pelatti
• Mark Pellowski, PH.D., CCC-SLP
• Thomas M Pembroke, MD
• Ely Roman Peralta, LCSW-C, LICSW, LCSW
• Gabrielle Joan Pereira, PHD
• Karen Zena B Pereira, PT
• Laura A Perell, D.D.S.
• Dashira Perez Ramirez

• Athletic Trainer in Towson, MD
• Providers in Towson, MD by specialty
• Athletic Trainer in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2014; 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.