Provider Demographics
NPI:1144847435
Name:VAVREK, JOSEPH P (HEARING AID FITTER)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:P
Last Name:VAVREK
Suffix:
Gender:M
Credentials:HEARING AID FITTER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 WELLES ST
Mailing Address - Street 2:
Mailing Address - City:FORTY FORT
Mailing Address - State:PA
Mailing Address - Zip Code:18704-4968
Mailing Address - Country:US
Mailing Address - Phone:570-283-0524
Mailing Address - Fax:
Practice Address - Street 1:190 WELLES ST
Practice Address - Street 2:
Practice Address - City:FORTY FORT
Practice Address - State:PA
Practice Address - Zip Code:18704-4968
Practice Address - Country:US
Practice Address - Phone:570-283-0524
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-02
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAF03117237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist