Provider Demographics
NPI:1619073467
Name:TRIGENIS, DESPINA (DO)
Entity Type:Individual
Prefix:
First Name:DESPINA
Middle Name:
Last Name:TRIGENIS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 HOLLOW TREE RIDGE RD
Mailing Address - Street 2:#1321
Mailing Address - City:DARIEN
Mailing Address - State:CT
Mailing Address - Zip Code:06820-5045
Mailing Address - Country:US
Mailing Address - Phone:203-202-9414
Mailing Address - Fax:
Practice Address - Street 1:137 HOLLOW TREE RIDGE RD
Practice Address - Street 2:#1321
Practice Address - City:DARIEN
Practice Address - State:CT
Practice Address - Zip Code:06820-5045
Practice Address - Country:US
Practice Address - Phone:203-202-9414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2015-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT046609207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH85074Medicare UPIN