Healthcare Provider Details

I. General information

NPI: 1013878172
Provider Name (Legal Business Name): MEGHAN GUZEWICZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/19/2025
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

835 LONG HILL RD APT A
MIDDLETOWN CT
06457-5029
US

IV. Provider business mailing address

835 LONG HILL RD APT A
MIDDLETOWN CT
06457-5029
US

V. Phone/Fax

Practice location:
  • Phone: 215-237-7418
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0000X
TaxonomyAdolescent Medicine (Family Medicine) Physician
License Number15720
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: