Provider Demographics
NPI:1114077658
Name:VAVREK, MICHAEL JOSEPH (AUD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JOSEPH
Last Name:VAVREK
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3322 US HIGHWAY 22 STE 204
Mailing Address - Street 2:
Mailing Address - City:BRANCHBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-3392
Mailing Address - Country:US
Mailing Address - Phone:908-722-4022
Mailing Address - Fax:908-722-4022
Practice Address - Street 1:3322 US HIGHWAY 22 STE 204
Practice Address - Street 2:
Practice Address - City:BRANCHBURG
Practice Address - State:NJ
Practice Address - Zip Code:08876-3392
Practice Address - Country:US
Practice Address - Phone:908-722-4022
Practice Address - Fax:908-722-4022
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT000764L231H00000X
NJ41YA00059500231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist