Provider Demographics
NPI:1790565133
Name:KUSZNIR, MAYA
Entity Type:Individual
Prefix:
First Name:MAYA
Middle Name:
Last Name:KUSZNIR
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 1:14996 KUTZTOWN RD
Mailing Address - Street 2:
Mailing Address - City:KUTZTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19530-8321
Mailing Address - Country:US
Mailing Address - Phone:610-780-2292
Mailing Address - Fax:
Practice Address - Street 1:2209 QUARRY DR STE A10
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19609-1153
Practice Address - Country:US
Practice Address - Phone:844-696-4631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-03
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
PASW140763OtherLICENSE