Individual
NERMINA BUKALO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
71 HAYNES ST, MANCHESTER, CT 06040-4131
(860) 540-6595
Mailing address
71 HAYNES ST, MANCHESTER, CT 06040-4131
(860) 540-6595
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
048166
CT
208M00000X
Hospitalist Physician
Primary
224430
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2143143
—
MA
Enumeration date
03/14/2006
Last updated
08/24/2015
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