Healthcare Provider Details

I. General information

NPI: 1891972931
Provider Name (Legal Business Name): JANET E. FAVINGER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2008
Last Update Date: 11/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25255 GRAVEL HILL RD
MILLSBORO DE
19966-3468
US

IV. Provider business mailing address

25255 GRAVEL HILL RD
MILLSBORO DE
19966-3468
US

V. Phone/Fax

Practice location:
  • Phone: 302-934-1471
  • Fax: 302-934-9687
Mailing address:
  • Phone: 302-934-1471
  • Fax: 302-934-9687

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number03-0000068
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number03-0000067
License Number StateDE
# 3
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number02-0000122
License Number StateDE

VIII. Authorized Official

Name: MRS. JANET E FAVINGER
Title or Position: OWNER
Credential:
Phone: 302-934-1471