Healthcare Provider Details

I. General information

NPI: 1831383371
Provider Name (Legal Business Name): RICHARD A LEVIN, MD,DMD,LAWRENCE J. FLIEGELMAN, M.D.,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2007
Last Update Date: 10/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 POST RD SUITE 302
FAIRFIELD CT
06824-6016
US

IV. Provider business mailing address

1305 POST RD SUITE 302
FAIRFIELD CT
06824-6016
US

V. Phone/Fax

Practice location:
  • Phone: 203-259-4700
  • Fax: 203-259-0328
Mailing address:
  • Phone: 203-259-4700
  • Fax: 203-259-0328

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number040346
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License Number039424
License Number StateCT
# 3
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number032601
License Number StateCT

VIII. Authorized Official

Name: MAEVE HARRIGAN
Title or Position: OFFICE MANAGER
Credential:
Phone: 203-259-4700