Provider Demographics
NPI:1063717957
Name:DEAN HAR MD LLC
Entity type:Organization
Organization Name:DEAN HAR MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-298-9191
Mailing Address - Street 1:2044 BRIDGEPORT AVE STE B
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-4633
Mailing Address - Country:US
Mailing Address - Phone:203-298-9191
Mailing Address - Fax:203-298-9194
Practice Address - Street 1:2044 BRIDGEPORT AVE STE B
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-4633
Practice Address - Country:US
Practice Address - Phone:203-298-9191
Practice Address - Fax:203-298-9194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-24
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT037056207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTD100042536OtherMEDICARE-PTAN