Atanasio Gaetano Fava, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

018715 Issued in NY

Practice address

622 W 168TH St
VC 10 Area D
New York, NY 10032-3720

Phone

(212) 342-1627

Fax

(212) 342-2112

NPI assigned

Apr 10, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1207785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350604800000",
    "number": "1861665929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 W 168TH ST",
            "address_2": "VC 10, RM 1001",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323720",
            "telephone_number": "212-342-1627",
            "fax_number": "212-342-2112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 W 168TH ST",
            "address_2": "VC 10 AREA D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323720",
            "telephone_number": "212-342-1627",
            "fax_number": "212-342-2112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAVA",
        "first_name": "ATANASIO GAETANO",
        "name_prefix": "Mr.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-10",
        "last_updated": "2012-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "018715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olunetachenia Fausta, RN
• Arline Faustin, M.D.
• Li Faustino, PH.D.
• Margaret Fauver
• Anissa Rose Fava, LMHC-D
• Clara Elizabeth Favale, PT
• Maria Favale, PHARMD
• Roberta S Favant
• Favate Neurology PC
• Albert Favate, MD

• Speech-Language Pathologist in New York, NY
• Providers in New York, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2012; 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.