Individual
BRENT DENMAN WAINWRIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
18 E SHORE RD, NEW PRESTON, CT 06777-1628
(484) 868-9998
(860) 393-1079
Mailing address
18 E SHORE RD, NEW PRESTON, CT 06777-1628
(484) 868-9998
(860) 393-1079
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
234018
NY
207N00000X
Dermatology Physician
Primary
43818
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03454060
—
NY
01
—
A400093374
MEDICARE PTAN
NY
Enumeration date
02/06/2006
Last updated
10/10/2024
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