Provider Demographics
NPI:1275532541
Name:HALDAS, JASON R (MD)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:R
Last Name:HALDAS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3 SHAWS CV
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NEW LONDON
Mailing Address - State:CT
Mailing Address - Zip Code:06320-4952
Mailing Address - Country:US
Mailing Address - Phone:860-439-1770
Mailing Address - Fax:860-447-2854
Practice Address - Street 1:3 SHAWS CV
Practice Address - Street 2:SUITE 201
Practice Address - City:NEW LONDON
Practice Address - State:CT
Practice Address - Zip Code:06320-4952
Practice Address - Country:US
Practice Address - Phone:860-439-1770
Practice Address - Fax:860-447-2854
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2010-08-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT040056207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001400564Medicaid
CT001400564Medicaid
H57136Medicare UPIN