Individual
CARISSA FAVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
365 MONTAUK AVE, NEW LONDON, CT 06320-4700
(401) 632-8362
Mailing address
1 CLEO CT, WESTERLY, RI 02891-1334
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
PCT.0013810
CT
183500000X
Pharmacist
Primary
RPH05471
RI
Other
Enumeration date
08/06/2015
Last updated
05/11/2026
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