Healthcare Provider Details

I. General information

NPI: 1093716938
Provider Name (Legal Business Name): ALAN DAVID DREZNER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 SEYMOUR ST
HARTFORD CT
06106-3315
US

IV. Provider business mailing address

28 WRIGHT DR
AVON CT
06001-2106
US

V. Phone/Fax

Practice location:
  • Phone: 860-522-4158
  • Fax: 860-524-2652
Mailing address:
  • Phone: 860-677-8870
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number015495
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number015495
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number015495
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: