Individual
CHRISTINE AIGBOGUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
21 GRAND ST, HARTFORD, CT 06106-1541
(860) 550-7500
Mailing address
967 ASYLUM AVE APT 11Q, HARTFORD, CT 06105-2414
(609) 214-7174
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5420
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101682731
—
CT
Enumeration date
11/19/2021
Last updated
11/19/2021
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