Individual
ALBERT FAVATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
222 E 41ST ST, NEW YORK, NY 10017-6739
(212) 263-7744
(212) 263-7721
Mailing address
222 E 41ST ST, NEW YORK, NY 10017-6739
(212) 263-7744
(212) 263-7721
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
161583
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01602400
—
NY
01
—
043695466
TAX ID
—
01
—
161583
STATE LICENSE
—
01
—
22621
ELDERPLAN
—
01
—
2814995
AETNA HMO
—
01
—
3656599
AETNA
—
01
—
3C6334
HEALTHNET
—
01
—
4637585
AETNA PPO
—
01
—
548N01
BCBS
—
01
—
548N02
BCBS
—
01
—
6016100
GHI
—
01
—
P00072195
RAILROAD MEDICARE
—
01
—
P3239454
OXFORD
—
Enumeration date
10/03/2006
Last updated
03/29/2021
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