Basic Information
| Provider Information | |||||||||
| NPI: | 1205890852 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GUZIK | ||||||||
| FirstName: | HEIDI | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | AU.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1305 POST ROAD SUITE 302 | ||||||||
| Address2: | RICHARD LEVIN MD & LAWRENCE J. FLIEGELMON MD LLC | ||||||||
| City: | FAIRFIELD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 06824 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2032594700 | ||||||||
| FaxNumber: | 2032590328 | ||||||||
| Practice Location | |||||||||
| Address1: | 1305 POST ROAD SUITE 302 | ||||||||
| Address2: | RICHARD LEVIN MD & LAWRENCE J. FLIEGELMON MD LLC | ||||||||
| City: | FAIRFIELD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 06824 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2032594700 | ||||||||
| FaxNumber: | 2032590328 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/12/2006 | ||||||||
| LastUpdateDate: | 11/20/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | 394 | WI | N | Speech, Language and Hearing Service Providers | Audiologist | 231H00000X | 000571 | CT | Y | Speech, Language and Hearing Service Providers | Audiologist |
ID Information
| ID | Type | State | Issuer | Description | 41145000 | 05 | WI | MEDICAID | 60646 | 01 | WI | DEAN HEALTH INSURANCE | OTHER |