Provider Demographics
NPI:1437039419
Name:DVORKES, REVA MIRIAM (RN BSN)
Entity type:Individual
Prefix:MRS
First Name:REVA
Middle Name:MIRIAM
Last Name:DVORKES
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 HILTON DR
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-5356
Mailing Address - Country:US
Mailing Address - Phone:718-387-1800
Mailing Address - Fax:718-513-2620
Practice Address - Street 1:11 HILTON DR
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-5356
Practice Address - Country:US
Practice Address - Phone:718-387-1800
Practice Address - Fax:718-513-2620
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-02
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY620974163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health