Individual
KELLY OLINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
310 CEDAR ST DEPT OF, NEW HAVEN, CT 06510-3218
(203) 737-8875
(203) 737-4067
Mailing address
310 CEDAR ST DEPT OF, NEW HAVEN, CT 06510-3218
(203) 737-8875
(203) 737-4067
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
61766
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
352498502
—
TX
01
—
352498503
MEDICAID CSHCN
TX
Enumeration date
01/19/2007
Last updated
10/17/2018
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