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General NPI Number Information
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NPI Number | 1932527652
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Entity Type | Individual
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Provider Name | KERSHA PENNICOTT MD
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Gender | Female
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Dates
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Enumeration Date | 03/31/2014
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | ATRIA 36 E 57TH STREET 45TH FL.
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City | NEW YORK
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State | NY
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Zip | 10022
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Country | US
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Telephone | 212-600-2000
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Fax | 914-607-4731
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Provider Business Mailing Address
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Address Line | 800 WESTCHESTER AVE STE N715
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City | RYE BROOK
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State | NY
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Zip | 10573-1369
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Country | US
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Telephone | 914-607-5730
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Fax | 914-457-1195
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 132150
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 310013
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License Number State | NY
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