Provider Demographics
NPI:1366898504
Name:MUSZYNSKI, MARK
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:MUSZYNSKI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44650 DELCO BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48313-1063
Mailing Address - Country:US
Mailing Address - Phone:586-254-1770
Mailing Address - Fax:586-254-3515
Practice Address - Street 1:44650 DELCO BLVD STE 100
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48313-1063
Practice Address - Country:US
Practice Address - Phone:586-254-1770
Practice Address - Fax:586-254-3515
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-06
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI3501013959237700000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
No174400000XOther Service ProvidersSpecialist