Organization
KETAREVIVE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH AFFORTUNATO DO (PARTNER)
(516) 225-3336
Entity
Organization
Contact information
Practice address
541 CEDAR HILL AVE, 2ND FLOOR, WYCKOFF, NJ 07481
(201) 212-6735
Mailing address
19 ROXBURY RD, MAHWAH, NJ 07430-1641
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Enumeration date
07/17/2024
Last updated
03/18/2025
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