Individual
GADA M ABDELHAFIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
365 MONTAUK AVE, NEW LONDON, CT 06320-4700
(860) 271-4364
Mailing address
365 MONTAUK AVE, NEW LONDON, CT 06320-4700
(860) 271-4364
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
045806
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000577026
ANTHEM
IN
01
—
045806
LICENSE
CT
Enumeration date
10/02/2007
Last updated
11/15/2013
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