Healthcare Provider Details

I. General information

NPI: 1629727524
Provider Name (Legal Business Name): DEBBY WAJSBAUM AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS DEBBY WALKIN

II. Dates (important events)

Enumeration Date: 03/20/2022
Last Update Date: 06/25/2024
Certification Date: 06/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 TAYLORS MILLS RD
MANALAPAN NJ
07726-3281
US

IV. Provider business mailing address

15 SAMI DR
HOWELL NJ
07731-2909
US

V. Phone/Fax

Practice location:
  • Phone: 732-462-8412
  • Fax:
Mailing address:
  • Phone: 347-533-0375
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number41YA00131400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: