| Philip A Penepent Jr. | |
|
5196 Genesee St Bowmansville NY 14026-1038 | |
| (716) 681-1895 | |
| (716) 681-5439 |
| Full Name | Philip A Penepent Jr. |
|---|---|
| Speciality | Internal Medicine |
| Location | 5196 Genesee St, Bowmansville, New York |
| Authorized Official Name and Position | Philip A Penepent (SOLE PROPRIETOR) |
| Authorized Official Contact | 7166811895 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Philip A Penepent Jr. 5196 Genesee St Bowmansville NY 14026-1038 Ph: (716) 681-1895 | Philip A Penepent Jr. 5196 Genesee St Bowmansville NY 14026-1038 Ph: (716) 681-1895 |
| NPI Number | 1255526570 |
|---|---|
| Provider Enumeration Date | 09/10/2007 |
| Last Update Date | 01/30/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255526570 | NPI | - | NPPES |
| 00751193 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |