Provider Demographics
NPI:1104918978
Name:BRAUNINGER, STEPHEN
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:BRAUNINGER
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 1:104 ENDICOTT ST
Mailing Address - Street 2:STE 100
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-3623
Mailing Address - Country:US
Mailing Address - Phone:978-745-6601
Mailing Address - Fax:
Practice Address - Street 1:55 HIGHLAND AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-2100
Practice Address - Country:US
Practice Address - Phone:978-745-6601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA584231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA023664Medicare ID - Type Unspecified