Individual
MRS. VIVIEN A ILOEJE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
94 CONNECTICUT BLVD, EAST HARTFORD, CT 06108-3013
(860) 528-1359
(860) 290-4142
Mailing address
94 CONNECTICUT BLVD, EAST HARTFORD, CT 06108-3013
(860) 528-1359
(860) 290-4142
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
040458
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004236164
—
CT
01
—
010040458CT
BCBS
CT
01
—
458040
CTC
CT
Enumeration date
04/06/2006
Last updated
10/17/2011
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