NPI 1023739273

Edward Revere

Practitioner Peer Specialist Buffalo, NY

Practice location

Address: 1021 Broadway St, Buffalo, NY 14212-1460
Phone: (716) 662-2040
Fax: (716) 662-0019
Mailing address: 227 Thorn Ave, Orchard Park, NY 14127-2600

Registered specialties (2)

Peer Specialist Primary

Other Service Providers Taxonomy 175T00000X Licence NYCPS-P4548 (NY)

Other Peer Specialist providers in New York →

Peer Specialist

Other Service Providers Taxonomy 175T00000X Licence CRPA-5254 (NY)

Registry record

NPI: 1023739273
Entity type: Individual
Sex (as registered): Male
NPI issued: 7 Sep 2022
Record last updated: 7 Sep 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.