Provider Demographics
NPI:1831383371
Name:RICHARD A LEVIN, MD,DMD,LAWRENCE J. FLIEGELMAN, M.D.,LLC
Entity type:Organization
Organization Name:RICHARD A LEVIN, MD,DMD,LAWRENCE J. FLIEGELMAN, M.D.,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MAEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-259-4700
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-28
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT040346207K00000X
CT039424207YX0905X
CT032601207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Multi-Specialty
No207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
C02764Medicare PIN