Dominque Jill Pesansky, M. ED, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-15-18977

Practice address

3744 W Chester Pike
Newtown Square, PA 19073-3224

Phone

(610) 864-7376

NPI assigned

Aug 9, 2016

Sex

Female

Sole proprietor

No

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 Education

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

{
    "created_epoch": "1470700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470700800000",
    "number": "1922552850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3744 W CHESTER PIKE",
            "city": "NEWTOWN SQUARE",
            "state": "PA",
            "postal_code": "190733224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3744 W CHESTER PIKE",
            "city": "NEWTOWN SQUARE",
            "state": "PA",
            "postal_code": "190733224",
            "telephone_number": "610-864-7376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PESANSKY",
        "first_name": "DOMINQUE JILL",
        "credential": "M. ED, BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-09",
        "last_updated": "2016-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-15-18977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Penn Ba Systems
• Spencer L Penn, D.O.
• Pennsylvania Agency of Nurses
• Pennsylvania CVS Pharmacy, L.L.C.
• Karen Elizabeth Pentz, LCSW
• Leslie Peters RN
• Doreen Nicosia Peterson, OTR/L
• Amanda Pettinelli, LMFT
• Pharmacy Exchange, Inc.
• Kathryn Phillips

• Behavior Analyst in Newtown Square, PA
• Providers in Newtown Square, PA by specialty
• Behavior Analyst in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 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.

Verify at the official NPI Registry.