Revello, Patrick John

Revello, Patrick John is an individual health care provider with primary practice located at 600 Coventry Dr , Phillipsburg NJ 08865-1971. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Revello, Patrick John can be contacted via phone (908) 454-4070.

Contact Information

Primary practice address
600 Coventry Dr Phillipsburg NJ 08865-1971
Phone: (908) 454-4070
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Professional 101YP2500X 37PC00601200 New Jersey

Profile Details

NPI number 1245580976
LBN Legal business name Revello, Patrick John
Credentials MA, LPC
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 10th, 2012
Last updated Mar 17th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245580976 NPPES
New Jersey Other 7794703 AGENCY PROGRAM PROVIDER #
New Jersey Other 0023701 AGENCY PROGRAM PROVIDER #

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