Individual
ELYSE J REVERE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
151 CENTENNIAL AVE, PISCATAWAY, NJ 08854-3907
(800) 969-5300
Mailing address
671 HOES LN W, PISCATAWAY, NJ 08854-8021
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
44SL05635000
NJ
Other
Enumeration date
09/22/2010
Last updated
09/22/2010
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