Revive Health and Aesthetics PC

NPI #1104644145 in East Longmeadow, Massachusetts

Provider Information

NPI Number: 1104644145
Entity Type: Organization
Organization Name: Revive Health and Aesthetics PC
Primary Specialty: Dermatology
Enumeration Date: Sep 30, 2024
Last Updated: Sep 30, 2024

Practice Location

Address: 294 N MAIN ST
City: East Longmeadow
State: Massachusetts
ZIP Code: 01028-1838
Phone: (413) 224-1009

Authorized Official

Name: DR. ADEKUNLE A. FAJANA, MD
Title: PRESIDENT
Phone: (508) 735-3280

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dermatology	207N00000X	Primary

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