Bolognia, Jean L

Bolognia, Jean L is an individual health care provider with primary practice located at 15 York St , New Haven CT 06510-3221. She recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as her primary health care specialty. Bolognia, Jean L can be contacted via phone (203) 785-4632.

Contact Information

Primary practice address
15 York St New Haven CT 06510-3221
Fax: (203) 785-3315
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 025790 Connecticut

Profile Details

NPI number 1942291331
LBN Legal business name Bolognia, Jean L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 3rd, 2005
Last updated May 22nd, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942291331 NPPES
Connecticut MEDICAID 001257906

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