Elissa Ann Favata, MD

Primary specialty

Preventive Medicine/Occupational Environmental Medicine PhysicianTaxonomy code 2083P0500X

License

25MA04036200 Issued in NJ

Practice address

1401 Route 70 East, Suite 14
South Jersey Medical Center
Cherry Hill, NJ 08034

Phone

(856) 216-1100

Fax

(856) 216-0484

NPI assigned

Dec 14, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184112000000",
    "number": "1619039971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 ROUTE 70 EAST, SUITE 14",
            "address_2": "SOUTH JERSEY MEDICAL CENTER",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "08034",
            "telephone_number": "856-216-1100",
            "fax_number": "856-216-0484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 ROUTE 70 EAST, SUITE 14",
            "address_2": "SOUTH JERSEY MEDICAL CENTER",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "08034",
            "telephone_number": "856-216-1100",
            "fax_number": "856-216-0484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAVATA",
        "first_name": "ELISSA",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-14",
        "last_updated": "2007-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA04036200",
            "primary": false
        },
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "NJ",
            "license": "25MA04036200",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD046205L",
            "primary": false
        },
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "PA",
            "license": "MD046205L",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DE",
            "license": "C1-0004751",
            "primary": false
        },
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "DE",
            "license": "C1-0004751",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justine Farnsworth, MSED
• Mary F Farren, D.M.D.
• Rachel Farreny
• Megan K Faulkner, MA, CCC/SLP
• Selena Faulknor
• William Fearn, MD
• Carann S. Feazell, M.S.S.W., L.C.S.W.
• Ashley Fede, PT
• Aaron Feibush
• Lisa Michelle Feifert, HIS

• Preventive Medicine/Occupational Environmental Medicine Physician in Cherry Hill, NJ
• Providers in Cherry Hill, NJ by specialty
• Preventive Medicine/Occupational Environmental Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.