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General NPI Number Information
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NPI Number | 1700874955
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Entity Type | Individual
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Provider Name | KEITH EDWARD PENNEY MD
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Gender | Male
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Dates
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Enumeration Date | 10/12/2005
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Last Update Date | 05/20/2019
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Provider Practice Location Address
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Address Line | 538 LITCHFIELD ST STE G01
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City | TORRINGTON
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State | CT
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Zip | 06790
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Country | US
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Telephone | 860-496-9877
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Fax | 860-496-0441
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Provider Business Mailing Address
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Address Line | 538 LITCHFIELD ST STE G01
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City | TORRINGTON
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State | CT
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Zip | 06790-6669
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Country | US
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Telephone | 860-496-9877
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Fax | 860-496-0441
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 039414
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License Number State | CT
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