Provider Demographics
NPI:1295862084
Name:HAESELER, FREDERICK DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:DAVID
Last Name:HAESELER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:62 HILLTOP RD
Mailing Address - Street 2:
Mailing Address - City:GUILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06437-3221
Mailing Address - Country:US
Mailing Address - Phone:203-453-6464
Mailing Address - Fax:293-737-4199
Practice Address - Street 1:367 CEDAR ST
Practice Address - Street 2:ESH 309
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-3222
Practice Address - Country:US
Practice Address - Phone:203-785-7082
Practice Address - Fax:203-737-4199
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT017832207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine