Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Revitalize Cny, LLC

Organization Medical Specialty Clinic/Center · NPI 1396103438

Revitalize Cny, LLC is a Medical Specialty Clinic/Center in Fayetteville, New York. Licensed in New York. Registered with an NPI since 2016.

Licensed in
NY
In the registry since
2016
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

6800 E Genesee St Ste 1200
Fayetteville, NY 13066-1089
Phone: (315) 251-1234
Fax: (315) 251-1144
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Specialty Clinic/Center (primary) Taxonomy 261QM2500X · Licence F335679 (NY)

Record details

NPI number1396103438
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Theresa Setter — Owner · (315) 251-1234
NPI enumeratedFebruary 3, 2016
Last updated in NPPESFebruary 3, 2016
Mailing address6800 E Genesee St, Suite 1200, Fayetteville, NY 13066-1089

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