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
Phone: (203) 785-4632
Fax: (203) 785-3315
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1942291331 | NPPES |
| Connecticut | MEDICAID | 001257906 |
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