Provider Demographics
NPI:1770199036
Name:HOMETOWN HEALTH CARE OF NEPA INC.
Entity Type:Organization
Organization Name:HOMETOWN HEALTH CARE OF NEPA INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLYSON
Authorized Official - Middle Name:KRISTEN
Authorized Official - Last Name:FAVUZZA
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, CRNP, FNP-C
Authorized Official - Phone:570-795-9795
Mailing Address - Street 1:921 DRINKER TPKE STE 13
Mailing Address - Street 2:
Mailing Address - City:COVINGTON TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18444-7948
Mailing Address - Country:US
Mailing Address - Phone:570-795-9795
Mailing Address - Fax:
Practice Address - Street 1:921 DRINKER TPKE STE 13
Practice Address - Street 2:
Practice Address - City:COVINGTON TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:18444-7948
Practice Address - Country:US
Practice Address - Phone:570-795-9795
Practice Address - Fax:570-276-0195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-21
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty