Individual
MR. PATRICK JOHN FAVA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
631 S COLLEGE AVE, ATHLETIC TRAINING ROOM, NEWARK, DE 19716-2010
(302) 831-8857
Mailing address
6477 83RD PL, MIDDLE VILLAGE, NY 11379-2434
(718) 507-2961
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
J3-0000524
DE
Other
Enumeration date
01/06/2015
Last updated
01/06/2015
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