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1265985600
LEIA MAREE FAVANO
PHILADELPHIA, PA
NPI
1265985600
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: PA SP014746)
Enumeration Date
2016-08-02
Last Update Date
2016-08-02
Business Address
-- LEIA MAREE FAVANO CRNP
3401 N BROAD ST
PHILADELPHIA, PA 19140-5103
Phone number: 215-707-2000
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Mailing Address
-- LEIA MAREE FAVANO CRNP
139 MORRIS AVE
WOODLYN, PA 19094-1717
Phone number: 484-574-3400
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