Individual
DR. JUSTIN DAVID PENNINGTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
41 MALL RD, BURLINGTON, MA 01805-4923
(781) 744-8000
Mailing address
41 MALL RD, BURLINGTON, MA 01805-0001
(401) 444-7076
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
1014091
MA
207W00000X
Ophthalmology Physician
LP04910
RI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/12/2019
Last updated
02/01/2024
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