Individual
KAREN MAXINE REAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
150 BERGEN ST, NEWARK, NJ 07103-2496
(973) 972-6680
Mailing address
617 ELLIS PKWY, PISCATAWAY, NJ 08854-4516
(732) 980-1250
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP001067400
NJ
Other
Enumeration date
05/24/2007
Last updated
07/08/2007
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