Provider Demographics
NPI:1720321300
Name:GINSBERG, KIMBERLY NICOLE (AUD)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:NICOLE
Last Name:GINSBERG
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:DR
Other - First Name:KIMBERLY
Other - Middle Name:NICOLE
Other - Last Name:BASILIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:1774 LENAPE UNIONVILLE RD
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-6920
Mailing Address - Country:US
Mailing Address - Phone:215-760-0751
Mailing Address - Fax:
Practice Address - Street 1:1774 LENAPE UNIONVILLE RD
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382-6920
Practice Address - Country:US
Practice Address - Phone:215-760-0751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-01
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YA00081500231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist