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Individual

DR. MARK PENNINGTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1 LAKE ST, GROVE HILL MEDICAL CENTER, NEW BRITAIN, CT 06052-1396
(860) 348-4242
(860) 348-4646
Mailing address
300 KENSINGTON AVE, GROVE HILL MEDICAL CENTER, NEW BRITAIN, CT 06051-3916
(860) 348-4242
(860) 348-4646

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
043011
CT
207NS0135X
Procedural Dermatology Physician
Primary
043011
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
010043011CT01
BCBS & BCFP ID
CT
01
043011
CONNECTICARE
CT
01
1255448155
GHMC GROUP NPI ID
CT
01
2V6529
HEALTH NET
CT
01
368233
WELLCARE MEDICARE
CT
01
3961986
AETNA
CT
01
5713161
CIGNA
CT
01
P00311000
RAIL ROAD MEDICARE ID
CT
01
P3616072
OXFORD
CT
Enumeration date
08/12/2005
Last updated
09/11/2025
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