Provider Demographics
NPI:1033354972
Name:FRAGAKIS, GREGORY T (AUD, FAAA)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:T
Last Name:FRAGAKIS
Suffix:
Gender:M
Credentials:AUD, FAAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7134 CALUMET AVE
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:IN
Mailing Address - Zip Code:46324-2406
Mailing Address - Country:US
Mailing Address - Phone:219-931-4725
Mailing Address - Fax:219-932-4028
Practice Address - Street 1:7134 CALUMET AVE
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:IN
Practice Address - Zip Code:46324-2406
Practice Address - Country:US
Practice Address - Phone:219-931-4725
Practice Address - Fax:219-932-4028
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-05
Last Update Date:2008-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN23002441A231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist