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General NPI Number Information
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NPI Number | 1821002346
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Entity Type | Individual
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Provider Name | ROBERT ALEXANDER BUCK OD
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Gender | Male
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Dates
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Enumeration Date | 07/28/2006
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Last Update Date | 08/11/2011
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Provider Practice Location Address
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Address Line | 171 N MAIN ST
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City | WATERBURY
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State | CT
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Zip | 06702
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Country | US
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Telephone | 203-754-8413
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Fax | 203-575-9921
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Provider Business Mailing Address
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Address Line | 116 N GEORGES HILL RD
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City | SOUTHBURY
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State | CT
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Zip | 06488-2626
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Country | US
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Telephone | 203-267-6796
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Fax | 203-267-6796
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | CT2294
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License Number State | CT
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