Healthcare Provider Details

I. General information

NPI: 1255241618
Provider Name (Legal Business Name): ALEXANDRA FIEDLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 BOSTON ST
GUILFORD CT
06437-2816
US

IV. Provider business mailing address

110 OLD BOSTON POST RD
OLD SAYBROOK CT
06475-2214
US

V. Phone/Fax

Practice location:
  • Phone: 203-974-2591
  • Fax:
Mailing address:
  • Phone: 203-376-0939
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: