Provider Demographics
NPI:1689075533
Name:SCHERLIZIN, GAUTHIER (HIS)
Entity Type:Individual
Prefix:
First Name:GAUTHIER
Middle Name:
Last Name:SCHERLIZIN
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7829 CHICAGO PLZ
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-3653
Mailing Address - Country:US
Mailing Address - Phone:402-933-1453
Mailing Address - Fax:402-763-8872
Practice Address - Street 1:7829 CHICAGO PLZ
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-3653
Practice Address - Country:US
Practice Address - Phone:402-933-1453
Practice Address - Fax:402-763-8872
Is Sole Proprietor?:No
Enumeration Date:2014-09-10
Last Update Date:2014-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE795237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist