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

Revived Soul Medical PC

Organization Psychiatry Physician · NPI 1821389941

Revived Soul Medical PC is a Psychiatry Physician in Brooklyn, New York. Licensed in New York. Registered with an NPI since 2011.

Licensed in
NY
In the registry since
2011
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1901 Avenue P 1A
Brooklyn, NY 11229-1342
Phone: (718) 382-5060
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X · Licence 246958 (NY)

Record details

NPI number1821389941
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Irina Kiblitsky — Owner · (718) 382-5060
NPI enumeratedApril 23, 2011
Last updated in NPPESApril 23, 2011
Mailing address1901 Avenue P, 1a, Brooklyn, NY 11229-1342

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