Graduated: 2022
Offers telehealth
NPI: 1851008544
Practice Locations (2)
REVIVED SOUL MEDICAL PC
1329 E 17TH ST
BROOKLYN, NY 112306052
7183825060
3380 NOSTRAND AVE, APT 1E
BROOKLYN, NY 112294032
9172680881
Source: CMS National Downloadable File, September 2026.