Individual
ILSE R. WIECHERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
300 GEORGE ST, SUITE 901, NEW HAVEN, CT 06511-6624
(203) 785-2117
Mailing address
300 GEORGE ST, SUITE 901, NEW HAVEN, CT 06511-6624
(203) 785-2117
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
048554
CT
2084P0805X
Geriatric Psychiatry Physician
048554
CT
Other
Enumeration date
02/27/2007
Last updated
03/06/2011
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