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General NPI Number Information
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NPI Number | 1881679009
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Entity Type | Individual
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Provider Name | EUGENIA MARIE DEL FAVERO GNP
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Gender | Female
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Dates
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Enumeration Date | 12/09/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 85 THORNTON AVE
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City | AUBURN
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State | NY
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Zip | 13021-4654
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Country | US
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Telephone | 315-253-7351
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Fax |
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Provider Business Mailing Address
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Address Line | 3138 MEADOW VIEW LN
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City | AUBURN
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State | NY
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Zip | 13021-9240
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Country | US
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Telephone | 315-253-4022
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | F340020
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License Number State | NY
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