Provider Demographics
NPI:1619126190
Name:REJNIN, MONIKA M (PA-C)
Entity type:Individual
Prefix:
First Name:MONIKA
Middle Name:M
Last Name:REJNIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MONIKA
Other - Middle Name:M
Other - Last Name:ZELAZNY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:29 HAYNES ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06040-4139
Mailing Address - Country:US
Mailing Address - Phone:860-533-6551
Mailing Address - Fax:
Practice Address - Street 1:360 TOLLAND TPKE STE 1A
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06042-1759
Practice Address - Country:US
Practice Address - Phone:844-482-7285
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-09
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002157363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1082975OtherNCCPA
CTD400001393Medicare PIN