Healthcare Provider Details

I. General information

NPI: 1477537991
Provider Name (Legal Business Name): HADEER SHAIKHLY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: HADEER ABDUL-RAHMAN M.D.

II. Dates (important events)

Enumeration Date: 11/30/2005
Last Update Date: 10/15/2026
Certification Date: 10/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1260 SILAS DEANE HWY STE 100
WETHERSFIELD CT
06109-4363
US

IV. Provider business mailing address

1260 SILAS DEANE HWY STE 104
WETHERSFIELD CT
06109-4363
US

V. Phone/Fax

Practice location:
  • Phone: 860-289-3375
  • Fax: 860-290-4108
Mailing address:
  • Phone: 860-289-3375
  • Fax: 860-290-4108

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number208476
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number208476
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number038284
License Number StateCT
# 4
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number038284
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: