Provider Demographics
NPI:1932899044
Name:PENZEL, JOSETTE ADRIANNA (DACCHM, LAC)
Entity Type:Individual
Prefix:
First Name:JOSETTE
Middle Name:ADRIANNA
Last Name:PENZEL
Suffix:
Gender:F
Credentials:DACCHM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 SAINT JAMES PL APT 1RR
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-6930
Mailing Address - Country:US
Mailing Address - Phone:516-563-2998
Mailing Address - Fax:
Practice Address - Street 1:66 SAINT JAMES PL APT 1RR
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-6930
Practice Address - Country:US
Practice Address - Phone:516-563-2998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-11
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007213171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist