NPI 1063700078

Ryan Elaine Bolton, PAC

Practitioner Medical Physician Assistant Groton, CT

Practice location

Address: 75 Eastern Point Rd Station A78, Groton, CT 06340-4905
Phone: (860) 433-5193

Registered specialties

Medical Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363AM0700X Licence 2528 (CT)

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Registry record

NPI: 1063700078
Entity type: Individual
Sex (as registered): Female
NPI issued: 12 Jul 2011
Record last updated: 12 Jul 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.