| Doctor Name: | ROBERT J BOOLBOL |
| NPI Number: | 1316935034 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 040205 |
| Business Practice Address: | 11 South Rd Suite 250 Farmington, CT - 060322483 |
| Business Phone Number: | 8606740222 |
| Business Fax Number: | 8606740024 |
| Mailing Address: | 67 Sand Pit Rd, Suite 308 DANBURY |
| State: | CT |
| Postal Code: | 068104032 |
| Phone Number: | 2037437246 |
| Fax Number: | 2037923920 |
| NPI Enumeration Date: | 10/06/2005 |
| NPI Last Update Date: | 11/14/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | 040205 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CT |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |