Healthcare Provider Details

I. General information

NPI: 1710594924
Provider Name (Legal Business Name): STEVEN JAMES GUZINSKI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2020
Last Update Date: 09/30/2020
Certification Date: 09/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

698 WEST AVE
NORWALK CT
06850-3379
US

IV. Provider business mailing address

73 FAIRLAWN AVE
BRIDGEPORT CT
06605-3432
US

V. Phone/Fax

Practice location:
  • Phone: 203-852-9903
  • Fax:
Mailing address:
  • Phone: 203-561-6404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number2105
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: