Revak, Caroll Ann

Revak, Caroll Ann is an sole proprietor health care provider with primary practice located at 1 Saredon Pl Suite 300, Rochester NY 14606-4070. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Revak, Caroll Ann can be contacted via phone (585) 426-8460.

Contact Information

Primary practice address
1 Saredon Pl Suite 300 Rochester NY 14606-4070
Phone: (585) 426-8460
Fax: (585) 426-8460
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 007402-1 New York

Profile Details

NPI number 1205863800
LBN Legal business name Revak, Caroll Ann
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 27th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205863800 NPPES
New York Other 100242FC PREFERRED CARE
New York Other 7700518 PREFERRED CARE
New York Other 7760102 PREFERRED CARE

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