Individual
DR. JOHN FRESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
234A BANK ST, 4TH FLOOR, NEW LONDON, CT 06320-6054
(860) 442-0290
(860) 442-2136
Mailing address
234A BANK ST, 4TH FLOOR, NEW LONDON, CT 06320-6054
(860) 442-0290
(860) 442-2136
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
031797
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010031797CT01
BLUECROSS
CT
05
—
1317975
—
CT
Enumeration date
04/20/2006
Last updated
12/19/2012
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