Provider Demographics
NPI:1962554550
Name:BULYGINA, OLGA ANDREYEVNA (MD)
Entity type:Individual
Prefix:DR
First Name:OLGA
Middle Name:ANDREYEVNA
Last Name:BULYGINA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2701 TAMARACK AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06074-5562
Mailing Address - Country:US
Mailing Address - Phone:860-647-8282
Mailing Address - Fax:860-647-8399
Practice Address - Street 1:2701 TAMARACK AVE
Practice Address - Street 2:
Practice Address - City:SOUTH WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06074-5562
Practice Address - Country:US
Practice Address - Phone:860-647-8282
Practice Address - Fax:860-647-8399
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT044577208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics