National Provider Identifier

Caroll Ann Revak, PH.D.

Caroll Ann Revak, PH.D. is listed in the NPPES registry with a primary specialty of Clinical Psychologist in Rochester, NY and a listed phone number of (585) 426-8460.

NPI 1205863800Rochester, NYClinical Psychologist

Profile Overview

NPI
1205863800
Provider Type
Individual
Primary Specialty
Clinical Psychologist
Enumeration Date
June 27, 2006
Last Updated
July 08, 2007

Practice Location

  • 1 Saredon Pl
  • Suite 300
  • Rochester, NY 14606-4070

Phone: (585) 426-8460

Specialties

  • Clinical Psychologist (103TC0700X)
Full Record
NPI
1205863800
Entity Type
Individual
Last Name
Revak
First Name
Caroll
Middle Name
Ann
Name Prefix
Dr.
Credential
PH.D.
Mailing Street Address
1 Saredon Pl
Mailing Address Line 2
Suite 300
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14606-4070
Mailing Country
US
Mailing Phone
(585) 426-8460
Mailing Fax
(585) 426-8460
Practice Street Address
1 Saredon Pl
Practice Address Line 2
Suite 300
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14606-4070
Practice Country
US
Practice Phone
(585) 426-8460
Practice Fax
(585) 426-8460
Enumeration Date
June 27, 2006
Last Updated
July 08, 2007
Sex
Female
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Clinical Psychologist (103TC0700X)
Other Identifiers
100242FC (NY, Preferred Care), 7700518 (NY, Doctor'S Health Plan Mvp), 7760102 (NY, Aetna)