Organization
COLCHESTER FAMILY MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OLAWALE AYENI MD (PHYSICIAN/OWNER)
(860) 537-3204
Entity
Organization
Contact information
Practice address
123 BROADWAY ST, COLCHESTER, CT 06415-1022
(860) 537-3204
(860) 537-3208
Mailing address
123 BROADWAY ST, P.O. BOX 288, COLCHESTER, CT 06415-1022
(860) 537-3204
(860) 537-3208
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
041093
—
Other
Enumeration date
09/06/2007
Last updated
08/19/2008
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