Organization
REVERSE TIME WELLNESS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NEISHELLE WALCOTT PA (PRESIDENT)
(203) 274-7426
Entity
Organization
Contact information
Practice address
1086 LONG RIDGE RD, STAMFORD, CT 06903-4404
(203) 274-7426
(203) 274-7426
Mailing address
1086 LONG RIDGE RD, STAMFORD, CT 06903-4404
(203) 274-7426
(203) 274-7426
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
02/13/2025
Last updated
04/08/2025
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