Provider Demographics
NPI:1508922188
Name:KOLESZAR, ALEXANDER SANDOR (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:SANDOR
Last Name:KOLESZAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 STEVENS ST
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06850-3852
Mailing Address - Country:US
Mailing Address - Phone:203-852-2293
Mailing Address - Fax:203-855-3985
Practice Address - Street 1:24 STEVENS ST
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06850-3852
Practice Address - Country:US
Practice Address - Phone:203-852-2293
Practice Address - Fax:203-855-3985
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0275022084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT14437OtherCONTROLLED SUBSTANCE
CT14437OtherCONTROLLED SUBSTANCE
CTD80774Medicare UPIN
CT260002338Medicare ID - Type Unspecified