Provider Demographics
NPI:1104048511
Name:TRIGENIS, ANTHONY EMMANUEL (MD)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:EMMANUEL
Last Name:TRIGENIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 510
Mailing Address - Street 2:
Mailing Address - City:NEW LONDON
Mailing Address - State:CT
Mailing Address - Zip Code:06320
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2 KARAOLI ST
Practice Address - Street 2:
Practice Address - City:ANIXIS
Practice Address - State:ATTIKIS
Practice Address - Zip Code:14569
Practice Address - Country:GR
Practice Address - Phone:01130210-621-9023
Practice Address - Fax:01130210-621-9023
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT025232207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine