Pennington, Mark
Pennington, Mark is an individual health care provider with primary practice located at 1 Lake St Grove Hill Medical Center, New Britain CT 06052-1396. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / Procedural Dermatology. Allopathic & Osteopathic Physicians / Dermatology is his primary health care specialty. Pennington, Mark can be contacted via phone (860) 348-4242.Contact Information
Primary practice address
1 Lake St Grove Hill Medical Center
New Britain CT 06052-1396
Phone: (860) 348-4242
Fax: (860) 348-4646
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 043011 | Connecticut |
| Allopathic & Osteopathic Physicians / Procedural Dermatology | 207NS0135X | 043011 | Connecticut |
Profile Details
| NPI number | 1720080476 |
|---|---|
| LBN Legal business name | Pennington, Mark |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 12th, 2005 |
| Last updated | Jul 9th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1720080476 | NPPES |
| Connecticut | Other | P00311000 | RAIL ROAD MEDICARE ID |
| Connecticut | Other | 1255448155 | RAIL ROAD MEDICARE ID |
| Connecticut | Other | 5713161 | RAIL ROAD MEDICARE ID |
| Connecticut | Other | 043011 | RAIL ROAD MEDICARE ID |
| Connecticut | Other | 3961986 | RAIL ROAD MEDICARE ID |
| Connecticut | Other | 368233 | RAIL ROAD MEDICARE ID |
| Connecticut | Other | 010043011CT01 | RAIL ROAD MEDICARE ID |
| Connecticut | Other | 2V6529 | RAIL ROAD MEDICARE ID |
| Connecticut | Other | P3616072 | RAIL ROAD MEDICARE ID |
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