Provider Demographics
NPI:1700641321
Name:DOWNIN, PENNY K
Entity Type:Individual
Prefix:MRS
First Name:PENNY
Middle Name:K
Last Name:DOWNIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 ANDES RD
Mailing Address - Street 2:
Mailing Address - City:DELHI
Mailing Address - State:NY
Mailing Address - Zip Code:13753-7443
Mailing Address - Country:US
Mailing Address - Phone:607-746-0329
Mailing Address - Fax:607-746-0474
Practice Address - Street 1:460 ANDES RD
Practice Address - Street 2:
Practice Address - City:DELHI
Practice Address - State:NY
Practice Address - Zip Code:13753-7443
Practice Address - Country:US
Practice Address - Phone:607-746-0329
Practice Address - Fax:607-746-0474
Is Sole Proprietor?:No
Enumeration Date:2024-02-14
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008527225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant