Provider Demographics
NPI:1972045789
Name:BALTZELL-MUSURAS, NANCY (AUD)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:BALTZELL-MUSURAS
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 1:570 EGG HARBOR RD STE B2
Mailing Address - Street 2:
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-2359
Mailing Address - Country:US
Mailing Address - Phone:856-589-6673
Mailing Address - Fax:856-589-3443
Practice Address - Street 1:570 EGG HARBOR RD STE B2
Practice Address - Street 2:
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-2359
Practice Address - Country:US
Practice Address - Phone:856-589-6673
Practice Address - Fax:856-589-3443
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-10
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE02-0000183231H00000X
NJ25MG00093500237600000X
NJ41YA00060500231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter