Revan Bennett

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

843119-01 Issued in NY

Practice address

2369 2ND Ave
New York, NY 10035-3108

Phone

(212) 876-2300

Fax

(212) 722-7618

NPI assigned

Dec 23, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1577059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776643200000",
    "number": "1730728734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2369 2ND AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100353108",
            "telephone_number": "212-876-2300",
            "fax_number": "212-722-7618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2369 2ND AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100353108",
            "telephone_number": "212-876-2300",
            "fax_number": "212-722-7618"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "321 W 125th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100273637",
            "country_code": "US",
            "telephone_number": "212-289-2378 x2509",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "REVAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-23",
        "last_updated": "2026-04-20",
        "certification_date": "2026-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "843119-01",
            "primary": true
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "325583-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Lee Bennett, M.D.
• Nataliya Bennett
• Norva J Bennett, L.AC.
• Rachell Bennett
• Rebecca Erin Bennett, MHC-LP
• Samantha Bennett, RN
• Shannon Marie Bennett, PH.D.
• Stephen J Bennett, DPM
• Stephen J. Bennett, M.D.
• Tristan Bennett, LMSW

• Registered Nurse in New York, NY
• Providers in New York, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.