Provider Demographics
NPI:1063248839
Name:S BUCCHERI MD PLLC
Entity type:Organization
Organization Name:S BUCCHERI MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SEBASTIANO
Authorized Official - Middle Name:
Authorized Official - Last Name:BUCCHERI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-266-5791
Mailing Address - Street 1:355 FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06114-2540
Mailing Address - Country:US
Mailing Address - Phone:860-266-5791
Mailing Address - Fax:872-241-0517
Practice Address - Street 1:355 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06114-2540
Practice Address - Country:US
Practice Address - Phone:860-707-2798
Practice Address - Fax:872-241-0517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-10
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty