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Organization
REVIVE BY CAROLINA, INC
Active
Organization
REVIVE BY CAROLINA, INC
Active
Other names
Jersey Hydreigth
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SANDRES MARTINEZ (MANAGER)
(201) 916-9544
Entity
Organization
Contact information
Practice address
1086 TEANECK RD STE 4F1, TEANECK, NJ 07666-4857
(201) 916-9544
Mailing address
1086 TEANECK RD STE 4F1, TEANECK, NJ 07666-4857
(201) 916-9544
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
—
NULL
207RI0200X
Infectious Disease Physician
Primary
—
—
Other
Enumeration date
07/13/2023
Last updated
09/19/2024
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