| Revcore Recovery Center Of Manhattan, Llc | |
|
15 2nd Ave Fl 3 Brooklyn NY 11215-2711 | |
| (718) 514-6007 | |
| Not Available |
| Full Name | Revcore Recovery Center Of Manhattan, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 15 2nd Ave Fl 3, Brooklyn, New York |
| Authorized Official Name and Position | Avraham Schick (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 2129669537 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Revcore Recovery Center Of Manhattan, Llc 15 2nd Ave Fl 3 Brooklyn NY 11215-2711 Ph: () - | Revcore Recovery Center Of Manhattan, Llc 15 2nd Ave Fl 3 Brooklyn NY 11215-2711 Ph: (718) 514-6007 |
| NPI Number | 1154094555 |
|---|---|
| Provider Enumeration Date | 07/30/2021 |
| Last Update Date | 07/30/2021 |
| Certification Date | 07/30/2021 |
| Medicare PECOS PAC ID | 7517344278 |
|---|---|
| Medicare Enrollment ID | O20220518001475 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154094555 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Jean Jeffrey Marcellus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881906766 PECOS PAC ID: 7214185404 Enrollment ID: I20120913000000 |
| Provider Name | Michelle M Knapp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104267061 PECOS PAC ID: 2769700384 Enrollment ID: I20150410002075 |
| Provider Name | Abigail B Strubel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568792158 PECOS PAC ID: 8820363781 Enrollment ID: I20171004000177 |
| Provider Name | Sarah B Cady |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427612795 PECOS PAC ID: 5193157907 Enrollment ID: I20191118000228 |
| Provider Name | Aleyamma John |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134739691 PECOS PAC ID: 5597168542 Enrollment ID: I20210728001576 |
| Provider Name | Lisa D White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073674321 PECOS PAC ID: 5496136467 Enrollment ID: I20220721003042 |
| Provider Name | Keisha Taylor-glanville |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346733441 PECOS PAC ID: 3274904354 Enrollment ID: I20230127002134 |
| Provider Name | Ruth D Habbouch |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1588206130 PECOS PAC ID: 0941648828 Enrollment ID: I20240411000597 |
| Provider Name | Michael J Polan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821773573 PECOS PAC ID: 9638619430 Enrollment ID: I20240907000095 |
| Provider Name | Farooq Kazi |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912314881 PECOS PAC ID: 4082052642 Enrollment ID: I20241115003303 |
| Provider Name | Catrina A Yuknevitch |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1215659479 PECOS PAC ID: 7719413939 Enrollment ID: I20241211004138 |
| Provider Name | Marawan M Elwakil |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1003345950 PECOS PAC ID: 0446789499 Enrollment ID: I20250121002980 |
| Provider Name | Robyn A Costa |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710493390 PECOS PAC ID: 3577092535 Enrollment ID: I20250121003239 |
| Provider Name | Amalia N Rudnik |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1144744715 PECOS PAC ID: 7113457979 Enrollment ID: I20250207002887 |
| Provider Name | Luis H Cajina |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437636883 PECOS PAC ID: 2062933229 Enrollment ID: I20250305000806 |
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