Individual
DOMINGO CP FAVALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1985 CROMPOND ROAD, BLDG D, CORTLANDT MANOR, NY 10567
(914) 739-1219
(914) 739-2353
Mailing address
2649 STRANG BLVD STE 304, YORKTOWN HEIGHTS, NY 10598-2938
(914) 739-0087
(914) 737-1714
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
157064
NY
208800000X
Urology Physician
Primary
MD478550
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01360925
—
NY
01
—
13769
AETNA HMO
NY
01
—
WS548
OXFORD
NY
Enumeration date
07/23/2006
Last updated
10/20/2023
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