Provider Demographics
NPI:1740228824
Name:FLIEGELMAN, LAWRENCE J (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:J
Last Name:FLIEGELMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1305 POST RD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-6016
Mailing Address - Country:US
Mailing Address - Phone:203-259-4700
Mailing Address - Fax:203-259-0328
Practice Address - Street 1:1305 POST RD
Practice Address - Street 2:SUITE 302
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-6016
Practice Address - Country:US
Practice Address - Phone:203-259-4700
Practice Address - Fax:203-259-0328
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT039424207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT010039424CT01OtherBLUE CROSS BLUE SHIELD
CT039424OtherCONNECTICARE
CT2V2100OtherPHS
CT4905456002OtherCIGNA
CT2973853OtherAETNA
CTP2396012OtherOXFORD
CT039424OtherCONNECTICARE