Trista R Pennington, PA-C
Physician Assistant, Medical in Bridgeport, Connecticut
1376103812- Practice location
- 267 Grant St, Bridgeport, CT 06610-2805
- Phone
- 203-988-5187
- Fax
- —
- Last updated
- September 18, 2022
Trista Rae Pennington is a Physician Assistant, Medical based in Bridgeport, CT. Trista Rae Pennington practices in Bridgeport, CT and has the professional credentials of PA-C. The NPI Number for Trista Rae Pennington is 1376103812 and holds a License No. 4561 (CT). The current practice location address for Trista Rae Pennington is 267 Grant St, Bridgeport, CT 06610-2805 and can be reached out via phone at 203-988-5187.
Provider Profile Details
- NPI Number
- 1376103812
- Provider Name
- Trista Rae Pennington
- Credential
- PA-C
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 267 Grant St, Bridgeport, CT 06610-2805
- Phone Number
- 203-988-5187
- Primary Taxonomy
- Physician Assistant, Medical · 363AM0700X
- Sole Proprietor
- Yes
- Provider Enumeration Date
- June 17, 2019
- Last Update Date
- September 18, 2022
- Certification Date
- September 18, 2022
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 267 Grant St
Bridgeport, CT 06610-2805 - City
- Bridgeport
- State
- Connecticut
- Zip
- 06610-2805
- Phone Number
- 203-988-5187
Provider Business Mailing Address Details
- Address
- 41 Melba St
Milford, CT 06460-7438 - City
- Milford
- State
- CT
- Zip
- 06460-7438
- Phone Number
- 860-334-7901
License Information
- License Number (1)
- 4561
- License State (1)
- CT
- Taxonomy (1)
- Physician Assistant, Surgical · 363AS0400X
- License Number (2)
- 4561
- License State (2)
- CT
- Taxonomy (2)
- Physician Assistant, Medical · 363AM0700X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Trista R Pennington, PA-C?
The NPI number of Trista R Pennington, PA-C is 1376103812. It was assigned on June 17, 2019 and is currently active in the NPPES registry.
What is the specialty of Trista R Pennington, PA-C?
Trista R Pennington, PA-C is registered under the primary taxonomy Physician Assistant, Medical (code 363AM0700X), licensed in CT under license number 4561.
Where does Trista R Pennington, PA-C practice?
The practice location is 267 Grant St, Bridgeport, CT 06610-2805. The office can be reached at 203-988-5187 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1376103812 directly on the NPPES registry website.