Healthcare Provider Details

I. General information

NPI: 1437122181
Provider Name (Legal Business Name): RICHARD MICHAEL GUZEWICZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2399 HIGHWAY 34 UNIT A, SUITE A2
MANASQUAN NJ
08736-1500
US

IV. Provider business mailing address

2399 HIGHWAY 34 UNIT A, SUITE A2
MANASQUAN NJ
08736-1500
US

V. Phone/Fax

Practice location:
  • Phone: 732-223-5665
  • Fax: 732-528-1983
Mailing address:
  • Phone: 732-223-5665
  • Fax: 732-528-1983

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number25MA05692600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: