Brent Penque

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

63784 Issued in CT

Practice address

230 S Frontage Rd
Child Study Center Atn: Tanya Colon
New Haven, CT 06519-1124

Phone

(203) 737-7129

NPI assigned

Apr 17, 2017

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1492387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571875200000",
    "number": "1376077339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 S FRONTAGE RD",
            "address_2": "CHILD STUDY CENTER ATN: TANYA COLON",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191124",
            "telephone_number": "203-737-7129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 S FRONTAGE RD",
            "address_2": "CHILD STUDY CENTER ATN: TANYA COLON",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191124",
            "telephone_number": "203-737-7129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENQUE",
        "first_name": "BRENT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-17",
        "last_updated": "2019-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "63784",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theresa Pennachio, LMFT
• Carley Danielle Pennecke
• Sean Michael Pennetti, MD
• Laurie E Pennington, LCSW
• Morgan Penny
• Mellisa A. Pensa, M.D.
• Maura Anne Penzi, CRNA, DNP
• Peoples Home Healthcare, Inc.
• Samantha Irene Pepe, AUD
• Jellyana Del Carmen Peraza Gonzalez, MD

• Psychiatry Physician in New Haven, CT
• Providers in New Haven, CT by specialty
• Psychiatry Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.