Provider Demographics
NPI:1386191864
Name:WHITTINGTON, PRISCILLA J (DVM, MPA)
Entity Type:Individual
Prefix:
First Name:PRISCILLA
Middle Name:J
Last Name:WHITTINGTON
Suffix:
Gender:F
Credentials:DVM, MPA
Other - Prefix:
Other - First Name:PRISCILLA
Other - Middle Name:J
Other - Last Name:WHITTINGTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DVM, MPA
Mailing Address - Street 1:PO BOX 1408
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06836-1408
Mailing Address - Country:US
Mailing Address - Phone:914-441-2456
Mailing Address - Fax:
Practice Address - Street 1:1336 EAST PUTNAM AVE
Practice Address - Street 2:
Practice Address - City:OLD GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06870
Practice Address - Country:US
Practice Address - Phone:914-441-2456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002402146D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTAW2418817OtherDEA