Individual
BUKOLA LOLA ONI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
445 S MAIN ST, WEST HARTFORD, CT 06110-1646
(860) 696-2200
(860) 561-7272
Mailing address
1290 SILAS DEANE HWY, HARTFORD HEALTHCARE-CVO, WETHERSFIELD, CT 06109-4337
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
71983
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
AR
Other
Enumeration date
04/11/2019
Last updated
08/02/2022
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