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Individual

ROBERT J BOOLBOL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
11 SOUTH RD, SUITE 250, FARMINGTON, CT 06032
(860) 674-0222
(860) 674-0024
Mailing address
11350 MCCORMICK RD, EXECUTIVE PLAZA 1, SUITE 501, HUNT VALLEY, MD 21031
(410) 329-1071
(410) 329-1054

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
040205
CT
207LP2900X
Pain Medicine (Anesthesiology) Physician
040205
CT
208VP0014X
Interventional Pain Medicine Physician
Primary
040205
CT

Other

Enumeration date
10/06/2005
Last updated
06/26/2018
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