Organization
RESTOREDHEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLIE LEVEILLE NP (OWNER)
(772) 834-2444
Entity
Organization
Contact information
Practice address
4 JOHN CALVIN DR, BLAUVELT, NY 10913-1001
(772) 834-2444
Mailing address
PO BOX 47, BLAUVELT, NY 10913-0047
(772) 834-2444
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
03/12/2020
Last updated
03/12/2020
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