Provider Demographics
NPI:1750370649
Name:CHIUSANO, ELIZABETH MOORE (MED, CCC-A)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:MOORE
Last Name:CHIUSANO
Suffix:
Gender:F
Credentials:MED, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 GOODALE RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07860-2782
Mailing Address - Country:US
Mailing Address - Phone:973-579-3791
Mailing Address - Fax:973-579-3984
Practice Address - Street 1:39 NEWTON SPARTA RD STE 1C
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:NJ
Practice Address - Zip Code:07860-2773
Practice Address - Country:US
Practice Address - Phone:973-383-4100
Practice Address - Fax:973-383-4104
Is Sole Proprietor?:No
Enumeration Date:2005-10-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MG00097400237600000X
NJ41YA00061500231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7684348OtherAETNA PROVIDER ID
NJ421530924OtherHORIZON BCBS PROVIDER ID
NJP2593832OtherOXFORD PROVIDER ID
NJ421530924OtherNJ CARPENTERS ID
NJ804073OtherHEALTH NETWORK AMERICA ID
NJ2203928OtherUNITED HEALTHCARE ID
NJ421530924OtherHORIZON BCBS PROVIDER ID