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Revive Psychiatry Services
Psychiatric/Mental Health Nurse Practitioner in Bridgeport, Connecticut
NPI 1831844877

Revive Psychiatry Services is a Psychiatric/Mental Health Nurse Practitioner based in Bridgeport, CT and is specialized in Psychiatric/Mental Health. Revive Psychiatry Services practices in Bridgeport, CT. The NPI Number for Revive Psychiatry Services is 1831844877 and holds a License No. (Connecticut).

The current practice location address for Revive Psychiatry Services is 130 Poplar St, Bridgeport, CT and can be reached out via phone at 203-536-8533.

Location: 130 Poplar St, Bridgeport, CT, 06605-1925
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1831844877
Provider Name
Revive Psychiatry Services
Credential
Provider Entity Type
Organization
Address
130 Poplar St, Bridgeport, CT, 06605-1925
Phone Number
203-536-8533
Fax Number
Provider Enumeration Date
02/17/2022
Last Update Date
03/13/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
6024487 05 CT
institution
Provider Business Practice Location Address Details
Address
130 Poplar St
City
Bridgeport
State
Connecticut
Zip
06605-1925
Phone Number
203-536-8533
Fax Number
person
Provider Business Mailing Address Details
Address
130 Poplar St
City
Bridgeport
State
Connecticut
Zip
06605-1925
Phone Number
203-536-8533
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Psychiatric/Mental Health
Taxonomy
363LP0808X
License No.
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Definition
Definition to come...
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