Individual
REVA JAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
870 PALISADE AVE, TEANECK, NJ 07666-3419
(201) 836-1663
Mailing address
3 UNIVERSITY PLZ STE 205, HACKENSACK, NJ 07601-6208
(201) 833-3000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00827900
NJ
Other
Enumeration date
06/26/2020
Last updated
06/25/2024
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