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Contact Information

KETAREVIVE, INC
541 CEDAR HILL AVE
2ND FLOOR
WYCKOFF, NJ07481
 Phone: 201-212-6735
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
Indicates primary specialty

NPI Profile & details for KETAREVIVE INC · (Female)

NPI Number 1235977893
Status Active
Credentials
Entity Individual
Enumeration date 07/17/2024
Last updated 03/18/2025 - More than a year ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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