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:
Health care specialties
Specialty | Code | License # | 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
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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