Provider Demographics
NPI:1255791695
Name:NUSZER, DEVIN KATHLEEN (CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:DEVIN
Middle Name:KATHLEEN
Last Name:NUSZER
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 BEACH 132ND ST
Mailing Address - Street 2:
Mailing Address - City:BELLE HARBOR
Mailing Address - State:NY
Mailing Address - Zip Code:11694-1410
Mailing Address - Country:US
Mailing Address - Phone:347-273-3490
Mailing Address - Fax:
Practice Address - Street 1:4001 18TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-5707
Practice Address - Country:US
Practice Address - Phone:718-436-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-27
Last Update Date:2016-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT004957235Z00000X
NY024586235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04338285Medicaid