National Provider Identifier
Edward Revere
Edward Revere is listed in the NPPES registry with a primary specialty of Peer Specialist in Buffalo, NY and a listed phone number of (716) 662-2040.
Profile Overview
- NPI
- 1023739273
- Provider Type
- Individual
- Primary Specialty
- Peer Specialist
- Enumeration Date
- September 07, 2022
- Last Updated
- September 07, 2022
Practice Location
- 1021 Broadway St
- Buffalo, NY 14212-1460
Phone: (716) 662-2040
Mailing Address
- 227 Thorn Ave
- Orchard Park, NY 14127-2600
Specialties
- Peer Specialist (175T00000X)
- Peer Specialist (175T00000X)
Full Record
- NPI
- 1023739273
- Entity Type
- Individual
- Last Name
- Revere
- First Name
- Edward
- Mailing Street Address
- 227 Thorn Ave
- Mailing City
- Orchard Park
- Mailing State
- NY
- Mailing ZIP Code
- 14127-2600
- Mailing Country
- US
- Mailing Phone
- (716) 662-2040
- Mailing Fax
- (716) 662-0019
- Practice Street Address
- 1021 Broadway St
- Practice City
- Buffalo
- Practice State
- NY
- Practice ZIP Code
- 14212-1460
- Practice Country
- US
- Practice Phone
- (716) 662-2040
- Practice Fax
- (716) 662-0019
- Enumeration Date
- September 07, 2022
- Last Updated
- September 07, 2022
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- September 07, 2022
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Peer Specialist (175T00000X), Peer Specialist (175T00000X)