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NPI Code Detail

MEDICARE: ALAN DAVID DREZNER MD

MEDICARE: ALAN DAVID DREZNER MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12086S0129XVascular Surgery Physician015495CT
22086S0102XSurgical Critical Care Physician015495CT
3208600000XSurgery Physician015495CT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1010015495CT01OTHERCTANTHEM BCBS
2070200-0403OTHERCTCONNECTICARE

General Provider Information

NPI Number : 1093716938
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALAN DAVID DREZNER MD
Provider Business Mailing Address
First Line : 28 WRIGHT DR
Second Line :
City : AVON
State : CT
Zip : 06001-2106
Country : US
Telephone Number : 860-677-8870
Fax Number :
Provider Business Practice Location Address
First Line : 80 SEYMOUR ST
Second Line :
City : HARTFORD
State : CT
Zip : 06106-3315
Country : US
Telephone Number : 860-522-4158
Fax Number : 860-524-2652
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2005
Last Update Date : 09/11/2025

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