Healthcare Provider Details

I. General information

NPI: 1619885233
Provider Name (Legal Business Name): MALGORZATA BUSELLI CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MALGORZATA HALAT

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 S CEDAR CREST BLVD STE 300
ALLENTOWN PA
18103-6381
US

IV. Provider business mailing address

416 RIVIERA DR
BLANDON PA
19510-9444
US

V. Phone/Fax

Practice location:
  • Phone: 610-402-3110
  • Fax:
Mailing address:
  • Phone: 484-553-3483
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP037023
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: