Provider Demographics
NPI:1881199263
Name:HAIMOVICH, ADRIAN DANIEL (MD, PHD)
Entity type:Individual
Prefix:
First Name:ADRIAN
Middle Name:DANIEL
Last Name:HAIMOVICH
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 DEACONESS RD FL 2
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-5321
Mailing Address - Country:US
Mailing Address - Phone:617-754-2400
Mailing Address - Fax:
Practice Address - Street 1:YALE NEW HAVEN HOSPITAL, EMERGENCY MEDICINE
Practice Address - Street 2:20 YORK ST
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-3220
Practice Address - Country:US
Practice Address - Phone:203-688-4242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-27
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA291550207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine