Individual
ZACHARY REVETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
140 W 6TH ST STE 210, OSWEGO, NY 13126-2554
(315) 349-5800
(315) 349-5800
Mailing address
140 W 6TH ST STE 210, OSWEGO, NY 13126-2554
(315) 349-5800
(315) 349-5785
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
033090
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/14/2023
Last updated
01/06/2025
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