Provider Demographics
NPI:1962444042
Name:CHRYSTAL, SUSAN J (AUD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:J
Last Name:CHRYSTAL
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:995 MOUNT EYRE RD
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON CROSSING
Mailing Address - State:PA
Mailing Address - Zip Code:18977-1503
Mailing Address - Country:US
Mailing Address - Phone:215-321-6172
Mailing Address - Fax:
Practice Address - Street 1:995 MOUNT EYRE RD
Practice Address - Street 2:
Practice Address - City:WASHINGTON CROSSING
Practice Address - State:PA
Practice Address - Zip Code:18977-1503
Practice Address - Country:US
Practice Address - Phone:215-321-6172
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YA00055900231H00000X
PAAT000960L231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist