Individual
LENA MULLALLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O
Contact information
Practice address
263 FARMINGTON AVE, FARMINGTON, CT 06032-1956
(860) 679-2839
Mailing address
263 FARMINGTON AVE, FARMINGTON, CT 06032-1956
(860) 679-2839
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
71979
CT
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/30/2013
Last updated
08/19/2022
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