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General NPI Number Information
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NPI Number | 1356497960
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Entity Type | Organization
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Legal Business Name | CENTER OF REVITALIZING PSYCHIATRY, P.C.
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 340 W PASSAIC ST STE 1
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City | ROCHELLE PARK
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State | NJ
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Zip | 07662-3019
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Country | US
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Telephone | 201-488-5161
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Fax | 201-488-5162
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Provider Business Mailing Address
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Address Line | 795 MAIN ST
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City | HACKENSACK
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State | NJ
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Zip | 07601-4812
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Country | US
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Telephone | 201-488-5161
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Fax | 201-488-5162
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | RIMMA BABESHKO
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Credential |
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Telephone | 201-488-5161
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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