Individual
LOLA BALOGUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
150 55TH ST, BROOKLYN, NY 11220-2508
(718) 630-6324
Mailing address
22017 106TH AVE, QUEENS VILLAGE, NY 11429-2428
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
264449-1
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/28/2008
Last updated
08/09/2022
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