Provider Demographics
NPI:1194495705
Name:PINUNSKY, EDWARD (FNP)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:
Last Name:PINUNSKY
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 FARMSTEAD RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06489-2461
Mailing Address - Country:US
Mailing Address - Phone:860-305-1500
Mailing Address - Fax:
Practice Address - Street 1:400 BRITTANY FARMS RD
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06053-1154
Practice Address - Country:US
Practice Address - Phone:860-224-3111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-15
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT9878363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily