Individual
DR. PAOLA REVECO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1 DIAMOND HILL RD, BERKELEY HEIGHTS, NJ 07922-2104
(908) 273-4300
Mailing address
5645 MAIN ST, FLUSHING, NY 11355-5045
(201) 988-0685
Taxonomy
Speciality
Code
Description
License number
State
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
Primary
25MB10917600
NJ
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
299096
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/30/2016
Last updated
02/09/2021
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