Provider Demographics
NPI:1629225479
Name:REVERTE, CHRISTOPHER MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:MICHAEL
Last Name:REVERTE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1111 AMSTERDAM AVENUE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025
Mailing Address - Country:US
Mailing Address - Phone:212-523-3981
Mailing Address - Fax:212-523-2186
Practice Address - Street 1:1111 AMSTERDAM AVENUE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025
Practice Address - Country:US
Practice Address - Phone:212-523-3981
Practice Address - Fax:212-523-2186
Is Sole Proprietor?:No
Enumeration Date:2008-08-23
Last Update Date:2015-01-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA110267207P00000X
NY265333207P00000X
FL117668207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine