# FAMILY MEDICINE PARTERSHIP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Bolton Familyand Sports Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992132161
- **Authorized official:** DR. RONALD BUCKMAN MD (OWNER)
- **Authorized official phone:** (860) 646-0649

## Contact information

- **Practice address:** 921 BOSTON TPKE, STE A, BOLTON, CT 06043-7403
- **Practice address phone:** (860) 646-0649
- **Practice address fax:** (860) 649-1995
- **Mailing address:** 921 BOSTON TPKE, STE A, BOLTON, CT 06043-7403
- **Mailing address phone:** (860) 646-0649
- **Mailing address fax:** (860) 649-1995

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LA2200X | Adult Health Nurse Practitioner | 5515 | CT | Yes |

## Other

- **Enumeration date:** 10/03/2013
- **Last updated:** 10/03/2013