Revitalize Cny, LLC
NPI #1396103438 in Fayetteville, New York
Provider Information
- NPI Number
- 1396103438
- Entity Type
- Organization
- Organization Name
- Revitalize Cny, LLC
- Primary Specialty
- Clinic/Center - Medical Specialty
- Enumeration Date
- Feb 3, 2016
- Last Updated
- Feb 3, 2016
Practice Location
- Address
- 6800 E GENESEE ST
- Address 2
- SUITE 1200
- City
- Fayetteville
- State
- New York
- ZIP Code
- 13066-1089
- Phone
- (315) 251-1234
Authorized Official
- Name
- THERESA M. SETTER, APRN-BC, DCNP
- Title
- OWNER
- Phone
- (315) 251-1234
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Medical Specialty — Medical Specialty |
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