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Individual

DR. JAMES PENNA

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
14 TECHNOLOGY DR, EAST SETAUKET, NY 11733-3472
(631) 444-4233
Mailing address
PO BOX 1559, STONY BROOK, NY 11790-0989
(631) 444-4233

Taxonomy

Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
209916
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02288966
NY
01
475F62
EMPIRE BC.BS
NY
01
7420388
AETNA
NY
Enumeration date
06/09/2006
Last updated
07/08/2007
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