Individual
ANA REVAZISHVILI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2011 OCEAN AVE APT 2D, BROOKLYN, NY 11230-6810
(929) 427-5363
Mailing address
2011 OCEAN AVE APT 2D, BROOKLYN, NY 11230-6810
(929) 427-5363
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
NY
Other
Enumeration date
03/12/2026
Last updated
03/12/2026
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