Individual
SAMUEL BUCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
464 CONGRESS AVE, SUITE #260, NEW HAVEN, CT 06519-1361
(203) 737-2644
Mailing address
11 LONGVIEW HEIGHTS RD, NEWTOWN, CT 06470-1907
(612) 280-7413
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
064215
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
03/23/2017
Last updated
02/24/2020
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