Individual
JOHN R FAVETTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
70 RIDGE RD, NORTH ARLINGTON, NJ 07031-6318
(201) 997-2332
(201) 997-6845
Mailing address
1255 BROAD ST STE 104, BLOOMFIELD, NJ 07003-3061
(973) 707-5632
(866) 806-3675
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
25MA03185400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3037908
—
NJ
Enumeration date
08/23/2006
Last updated
11/27/2023
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