| Chris Penta, Psy.d., Llc | |
|
46 Court St Windsor CT 06095-2909 | |
| (860) 285-8270 | |
| Not Available |
| Full Name | Chris Penta, Psy.d., Llc |
|---|---|
| Speciality | Psychologist |
| Location | 46 Court St, Windsor, Connecticut |
| Authorized Official Name and Position | Christopher Penta (MEMBER) |
| Authorized Official Contact | 8602858270 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chris Penta, Psy.d., Llc 46 Court St Windsor CT 06095-2909 Ph: (860) 285-8270 | Chris Penta, Psy.d., Llc 46 Court St Windsor CT 06095-2909 Ph: (860) 285-8270 |
| NPI Number | 1225389596 |
|---|---|
| Provider Enumeration Date | 09/27/2012 |
| Last Update Date | 09/27/2012 |
| Medicare PECOS PAC ID | 2163658089 |
|---|---|
| Medicare Enrollment ID | O20131126000041 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225389596 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 002378 (Connecticut) | Primary |
| Provider Name | Christopher R Penta |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1720178049 PECOS PAC ID: 3971739897 Enrollment ID: I20131126000058 |
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