| Revive Medical & Aesthetic Clinic | |
|
7313 Hanover Pkwy Ste A Greenbelt MD 20770-3667 | |
| (301) 412-5522 | |
| (301) 498-7436 |
| Full Name | Revive Medical & Aesthetic Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 7313 Hanover Pkwy Ste A, Greenbelt, Maryland |
| Authorized Official Name and Position | Florence Ukenye (CLINICAL DIRECTOR) |
| Authorized Official Contact | 3014125522 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Revive Medical & Aesthetic Clinic 7313 Hanover Pkwy Ste A Greenbelt MD 20770-3667 Ph: (301) 412-5522 | Revive Medical & Aesthetic Clinic 7313 Hanover Pkwy Ste A Greenbelt MD 20770-3667 Ph: (301) 412-5522 |
| NPI Number | 1104536358 |
|---|---|
| Provider Enumeration Date | 11/29/2022 |
| Last Update Date | 11/29/2022 |
| Medicare PECOS PAC ID | 6305202508 |
|---|---|
| Medicare Enrollment ID | O20231215000552 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104536358 | NPI | - | NPPES |
| NA | Other | NA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Florence Chinwe Ukenye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255722187 PECOS PAC ID: 9638480031 Enrollment ID: I20150625000847 |
| Provider Name | Felicitas Onyekweli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053020644 PECOS PAC ID: 5395101596 Enrollment ID: I20231215000936 |
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