Provider Demographics
NPI:1518377795
Name:NITZBERG, CAROL
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:
Last Name:NITZBERG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:566 HADDON AVE
Mailing Address - Street 2:
Mailing Address - City:COLLINGSWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08108-1444
Mailing Address - Country:US
Mailing Address - Phone:856-858-9314
Mailing Address - Fax:856-858-5672
Practice Address - Street 1:566 HADDON AVE
Practice Address - Street 2:
Practice Address - City:COLLINGSWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08108-1444
Practice Address - Country:US
Practice Address - Phone:856-858-9314
Practice Address - Fax:856-858-5672
Is Sole Proprietor?:No
Enumeration Date:2014-04-28
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator