Provider Demographics
NPI:1376778019
Name:NORMAN, GARRETT JOSEPH III (MD)
Entity Type:Individual
Prefix:DR
First Name:GARRETT
Middle Name:JOSEPH
Last Name:NORMAN
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 WESTMONT AVE
Mailing Address - Street 2:
Mailing Address - City:LAVALLETTE
Mailing Address - State:NJ
Mailing Address - Zip Code:08735-2037
Mailing Address - Country:US
Mailing Address - Phone:732-575-7835
Mailing Address - Fax:
Practice Address - Street 1:20 WESTMONT AVE
Practice Address - Street 2:
Practice Address - City:LAVALLETTE
Practice Address - State:NJ
Practice Address - Zip Code:08735-2037
Practice Address - Country:US
Practice Address - Phone:732-575-7835
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-26
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09266100207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine