Provider Demographics
NPI:1689648222
Name:BUCCI, JAMES GEORGE (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:GEORGE
Last Name:BUCCI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:199 OLD HARTFORD RD
Mailing Address - Street 2:UNIT #6
Mailing Address - City:COLCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06415-2739
Mailing Address - Country:US
Mailing Address - Phone:860-537-2262
Mailing Address - Fax:860-537-2273
Practice Address - Street 1:199 OLD HARTFORD RD
Practice Address - Street 2:UNIT #6
Practice Address - City:COLCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06415-2739
Practice Address - Country:US
Practice Address - Phone:860-537-2262
Practice Address - Fax:860-537-2273
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2011-09-20
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Provider Licenses
StateLicense IDTaxonomies
CT39103207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001391036Medicaid
CT001391036Medicaid
CT110008148Medicare ID - Type Unspecified