ELISSA ANN FAVATA MD NPI 1619039971

NPI Information

NPI: 1619039971
Provider Name: ELISSA ANN FAVATA, MD
Classification: Preventive Medicine - 2083P0500X
Entity Type: Individual

Specialization: Preventive Medicine/Occupational Environmental Medicine

PECOS Registration: Yes

Address:
1401 ROUTE 70 EAST, SUITE 14
SOUTH JERSEY MEDICAL CENTER
CHERRY HILL, NJ
ZIP 08034
Phone: (856) 216-1100
Get Directions

Elissa Ann Favata, MD is a preventive medicine/occupational environmental medicine preventive medicine in Cherry Hill, NJ. The provider is a preventive medicine physician who specializes in preventive medicine/occupational-environmental medicine, which is focused on protecting the population from occupational and environmental conditions. Elissa Ann Favata, MD NPI is 1619039971. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1401 ROUTE 70 EAST, SUITE 14
SOUTH JERSEY MEDICAL CENTER
CHERRY HILL, NJ
ZIP 08034
Phone: (856) 216-1100
Fax: (856) 216-0484

The NPI 1619039971 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 12/14/2006 and was last updated on 7/11/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207R00000X	Internal Medicine		MD046205L	PENNSYLVANIA	No
2	2083P0500X	Preventive Medicine	Preventive Medicine/Occupational Environmental Medicine	MD046205L	PENNSYLVANIA	No
3	207R00000X	Internal Medicine		C1-0004751	DELAWARE	No
4	2083P0500X	Preventive Medicine	Preventive Medicine/Occupational Environmental Medicine	C1-0004751	DELAWARE	No
5	207R00000X	Internal Medicine		25MA04036200	NEW JERSEY	No
6	2083P0500X	Preventive Medicine	Preventive Medicine/Occupational Environmental Medicine	25MA04036200	NEW JERSEY	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	C63225	MEDICARE UPIN	NEW JERSEY
2	574041	MEDICARE ID-TYPE UNSPECIFIED	NEW JERSEY	MEDICARE PROVIDER NO.

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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