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

Revive Health and Aesthetics PC

Organization Dermatology Physician · NPI 1104644145

Revive Health and Aesthetics PC is a Dermatology Physician in East Longmeadow, Massachusetts. Registered with an NPI since 2024.

In the registry since
2024
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

294 N Main St
East Longmeadow, MA 01028-1838
Phone: (413) 224-1009
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X

Record details

NPI number1104644145
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Adekunle Fajana — President · (508) 735-3280
NPI enumeratedSeptember 30, 2024
Last updated in NPPESSeptember 30, 2024
Certification dateSeptember 30, 2024
Mailing address294 N Main St, East Longmeadow, MA 01028-1838