Organization
JOHN R FAVETTA M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN R FAVETTA M.D.,P.A. (OWNER)
(201) 997-2332
Entity
Organization
Contact information
Practice address
70 RIDGE RD, NORTH ARLINGTON, NJ 07031-6318
(201) 997-2332
(201) 997-6845
Mailing address
70 RIDGE RD, NORTH ARLINGTON, NJ 07031-6318
(201) 997-2332
(201) 997-6845
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
25MA03185400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3037908
—
NH
Enumeration date
08/23/2006
Last updated
11/18/2014
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