Provider Demographics
NPI:1447752605
Name:CAVANNA, PATRICIA A (RNFA)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:A
Last Name:CAVANNA
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2A SWEENEY CT
Mailing Address - Street 2:
Mailing Address - City:MONTVALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07645-1786
Mailing Address - Country:US
Mailing Address - Phone:201-410-6179
Mailing Address - Fax:
Practice Address - Street 1:2A SWEENEY CT
Practice Address - Street 2:
Practice Address - City:MONTVALE
Practice Address - State:NJ
Practice Address - Zip Code:07645-1786
Practice Address - Country:US
Practice Address - Phone:201-410-6179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-05
Last Update Date:2018-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY9367031163WR0006X
NJ26NR12451400163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant