Individual
MR. CRAIG S FAVA
Active
Individual
MR. CRAIG S FAVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-011552-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00872660000
PERSONAL CHOICE
PA
01
—
2582353
AETNA HMO
PA
01
—
7148219
AETNA TRADITIONAL #
PA
Enumeration date
04/20/2006
Last updated
02/06/2025
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