Individual
EKATERINA V REVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
10 MEMBERS WAY STE 300, DOVER, NH 03820-5933
(603) 749-0913
Mailing address
7 PORTWALK PL UNIT 1414, PORTSMOUTH, NH 03801-7008
(774) 521-2157
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2088
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3143265
—
NH
Enumeration date
05/19/2020
Last updated
01/28/2026
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