Provider Demographics
NPI:1386842961
Name:PENKOWER, ARIEL (PSYM)
Entity Type:Individual
Prefix:MR
First Name:ARIEL
Middle Name:
Last Name:PENKOWER
Suffix:
Gender:M
Credentials:PSYM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:839 IRVINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:HILLSIDE
Mailing Address - State:NJ
Mailing Address - Zip Code:07205-3105
Mailing Address - Country:US
Mailing Address - Phone:908-994-1336
Mailing Address - Fax:
Practice Address - Street 1:2269 SAW MILL RIVER RD
Practice Address - Street 2:BUILDING 1A
Practice Address - City:ELMSFORD
Practice Address - State:NY
Practice Address - Zip Code:10523-3832
Practice Address - Country:US
Practice Address - Phone:914-345-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program