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Contact Information

KIM M BUCKO, OTR
2440 GOLD STAR HWY
SUITE 201
MYSTIC, CT06355-1180
 Phone: 860-536-1001
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Occupational Therapist

225X00000X 67 Occupational Therapist in Private Practice
 

Physical Therapy

261QP2000X
Indicates primary specialty

NPI Profile & details for KIM M BUCKO · (Female)

NPI Number 1922358266
Status Active
Credentials OTR (Registered Occupational Therapist)
Entity Individual
Enumeration date 09/13/2012
Last updated 10/21/2022 - About 4 years ago
Sole proprietor 1 Yes
Identifiers
  • CT License # 001892
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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