Individual
PROF. REVAY O CORBETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, PHD
Contact information
Practice address
185 NOBLE ST, BRENTWOOD, NY 11717-6512
(929) 352-3824
Mailing address
185 NOBLE ST, BRENTWOOD, NY 11717-6512
(929) 352-3824
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
002418
NY
Other
Enumeration date
06/08/2020
Last updated
06/14/2020
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