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General NPI Number Information
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NPI Number | 1639794720
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Entity Type | Individual
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Provider Name | ADRIENNE MARGAUX FAVORITO
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Gender | Female
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Dates
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Enumeration Date | 06/15/2020
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Last Update Date | 09/13/2021
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Provider Practice Location Address
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Address Line | 3959 BROADWAY
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City | NEW YORK
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State | NY
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Zip | 10032-1559
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Country | US
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Telephone | 845-499-8821
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Fax |
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Provider Business Mailing Address
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Address Line | 104 MASSACHUSETTS AVE
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City | CONGERS
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State | NY
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Zip | 10920-2504
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Country | US
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Telephone | 845-499-8821
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WN0002X
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Taxonomy Name | Neonatal Intensive Care Registered Nurse
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License Number | 689315
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LN0000X
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Taxonomy Name | Neonatal Nurse Practitioner
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License Number | F350497
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License Number State | NY
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