Individual
TAMMY LAUREN FAVARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
16 STORM DR, HOLTSVILLE, NY 11742-1905
(516) 658-5064
Mailing address
16 STORM DR, HOLTSVILLE, NY 11742-1905
(516) 658-5064
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
431903
NY
Other
Enumeration date
11/14/2020
Last updated
06/12/2023
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