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General NPI Number Information
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NPI Number | 1598737462
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Entity Type | Individual
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Provider Name | BRENT DENMAN WAINWRIGHT MD
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Gender | Male
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Dates
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Enumeration Date | 02/06/2006
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Last Update Date | 10/10/2024
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Provider Practice Location Address
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Address Line | 18 E SHORE RD
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City | NEW PRESTON
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State | CT
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Zip | 06777-1628
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Country | US
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Telephone | 484-868-9998
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Fax | 860-393-1079
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Provider Business Mailing Address
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Address Line | 18 E SHORE RD
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City | NEW PRESTON
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State | CT
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Zip | 06777-1628
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Country | US
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Telephone | 484-868-9998
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Fax | 860-393-1079
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 234018
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 43818
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License Number State | CT
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