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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

Other

Enumeration date
07/13/2023
Last updated
09/19/2024
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