Individual
LAJAUN FOGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
167 N CHESTNUT HILL RD, KILLINGWORTH, CT 06419-1002
(860) 510-1709
Mailing address
374 BROAD ST, NEW BRITAIN, CT 06053-3960
(860) 477-6681
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
NA9993981
CT
Other
Enumeration date
06/18/2021
Last updated
06/18/2021
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