Provider Demographics
NPI:1538538442
Name:CEDANO, FAVIO
Entity type:Individual
Prefix:MR
First Name:FAVIO
Middle Name:
Last Name:CEDANO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:192 NEPPERHAN AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-8929
Mailing Address - Country:US
Mailing Address - Phone:914-656-6572
Mailing Address - Fax:914-968-2183
Practice Address - Street 1:192 NEPPERHAN AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-8929
Practice Address - Country:US
Practice Address - Phone:914-656-6572
Practice Address - Fax:914-968-2183
Is Sole Proprietor?:No
Enumeration Date:2015-09-21
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver