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Organization
FAMILY MEDICINE PARTERSHIP
Active
Organization
FAMILY MEDICINE PARTERSHIP
Active
Other names
Bolton Familyand Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD BUCKMAN MD (OWNER)
(860) 646-0649
Entity
Organization
Contact information
Practice address
921 BOSTON TPKE, STE A, BOLTON, CT 06043-7403
(860) 646-0649
(860) 649-1995
Mailing address
921 BOSTON TPKE, STE A, BOLTON, CT 06043-7403
(860) 646-0649
(860) 649-1995
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
5515
CT
Other
Enumeration date
10/03/2013
Last updated
10/03/2013
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