Provider Demographics
NPI:1801249099
Name:GRAEBER, NORMAN
Entity type:Individual
Prefix:
First Name:NORMAN
Middle Name:
Last Name:GRAEBER
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 1:2501 COTTONTAIL LN
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-5125
Mailing Address - Country:US
Mailing Address - Phone:732-529-7185
Mailing Address - Fax:732-568-7915
Practice Address - Street 1:550 N MILITARY AVE
Practice Address - Street 2:SUITE 4A
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54303-4569
Practice Address - Country:US
Practice Address - Phone:920-497-4600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-22
Last Update Date:2016-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1494-60237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist