Healthcare Provider Details

I. General information

NPI: 1992723761
Provider Name (Legal Business Name): ROBERT A MUZZARELLI MA, CCC-A
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 PRINCE RD
GREENVILLE NC
27858-4939
US

IV. Provider business mailing address

206 PRINCE RD
GREENVILLE NC
27858-4939
US

V. Phone/Fax

Practice location:
  • Phone: 252-758-5621
  • Fax:
Mailing address:
  • Phone: 252-758-5621
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number383
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: