REVIVE PHYSICAL THERAPY (NPI# 1548702079) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548702079 |
| Entity Type | Organization |
| Organization Name | REVIVE PHYSICAL THERAPY |
| Practice Address |
1330a Rockland Ave Staten Island NY 10314-4944 |
| Mailing Address |
112 Bidwell Ave Staten Island NY 10314-3177 |
| Practice Telephone | 7186192259 |
| Enumeration Date | 2016-11-15 |
| Last Update Date | 2016-11-15 |
| Authorized Official Name | MR. TORY BADALAMENTI (PRESIDENT) |
| Authorized Official Telephone | 7186192259 |
| Authorized Official Credential | PT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251X0800X |
Physical Therapist Specialization: Orthopedic |
17990 | NY | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598038119 | Revive Physical Therapy | Physical Therapist | 904 S Walker St Ste B, Burgaw, NC 28425-5008 | 2012-02-13 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Iowa Business Entities | REVIVE PHYSICAL THERAPY AND WELLNESS, LLC | 1570 Se Waddell Way, Waukee, IA 50263 |
| Colorado Business Entities | Revive Physical Therapy, LLC | 980 Ute Lane, Gunnison, CO 81230 |
| Oregon Corporations, Companies and Business Names | REVIVE PHYSICAL THERAPY, LLC | 18091 Sw Lower Boones Ferry, Portland, OR 97224 |
| Colorado Business Entities | Revive Physical Therapy, PLLC | 14389 County Road 5, Mead, CO 80504 |
| Street Address |
1330A ROCKLAND AVE |
| City | STATEN ISLAND |
| State | NY |
| Zip Code | 10314-4944 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578866141 | Blessed Hands Rehab Pt PC | Case Management | 1330a Rockland Ave, Staten Island, NY 10314-4944 | 2010-12-21 |
| 1609346345 | Girgis Associates,inc. | Home Health | 1330a Rockland Ave, Staten Island, NY 10314-4944 | 2018-11-26 |
| 1548798671 | Tory Physical Therapy PC | Physical Therapist | 1330a Rockland Ave, Staten Island, NY 10314-4944 | 2017-06-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568076255 | Edward Leccese | Massage Therapist | 77 Renee Place, Staten Island, NY 10314 | 2020-09-01 |
| 1871154633 | Matthew Richard Puliatti | Counselor | 1688 Victory Boulevard, Staten Island, NY 10314 | 2019-06-24 |
| 1750845137 | Miriam Gordon Pediatric Np PC | Nurse Practitioner | 7 Ismay Street, Staten Island, NY 10314 | 2019-01-30 |
| 1003391186 | 2791 Richmond LLC | Dentist | 2791 Richmond Avenue, Suite 2, Staten Island, NY 10314 | 2018-09-25 |
| 1477046522 | Miriam A Madry | Optometrist | 569 Woolley Ave, Staten Island, NY 10314 | 2018-06-13 |
| 1174025894 | Staten Island Dentistry P.C. | Clinic/Center | 979 Willowbrook Rd., Staten Island, NY 10314 | 2018-03-08 |
| 1205335023 | Ashley Larsen | Early Intervention Provider Agency | 229 Wellington Ct, Staten Island, NY 10314 | 2018-02-07 |
| 1306369699 | Victoria Ali | Behavior Technician | 228 Melvin Avenue, Staten Island, NY 10314 | 2017-07-19 |
| 1700307360 | Lydia Mora | Specialist | 2025 Richmond Avenue Suite 200, Staten Island, NY 10314 | 2017-07-03 |
| 1366971707 | Lisa Pietracatella | Massage Therapist | 92 Margaretta Court, Staten Island, NY 10314 | 2017-06-08 |
| Find all providers in zip 10314 | ||||
| Taxonomy Code | 2251X0800X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Orthopedic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700196763 | Dmitry Choklin | Physical Therapist | 303 Mason Ave, Staten Island, NY 10305-3414 | 2010-10-08 |
| 1083717987 | Valerie Beth Harris | Physical Therapist | 274 Kell Ave, Staten Island, NY 10314-4114 | 2006-09-06 |
| 1568937134 | Matthew Peter Cutroneo | Physical Therapist | 4079 Richmond Ave, Staten Island, NY 10312-5633 | 2018-10-09 |
| 1376067140 | Anthony Ralph Liguori | Physical Therapist | 3391 Richmond Ave, Staten Island, NY 10312-2025 | 2017-08-02 |
| 1285969246 | Allyson Marie Kuga | Physical Therapist | 4079 Richmond Ave, Staten Island, NY 10312-5633 | 2009-10-08 |
| 1740485374 | Andrea Myszak | Physical Therapist | 355 Bard Ave, Staten Island, NY 10310-1664 | 2007-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538760152 | Molly Ripp | Physical Therapist | 1165 Northern Blvd Ste 403, Manhasset, NY 11030-3048 | 2020-11-02 |
| 1982202024 | Integrated Pt2 Pllc | Physical Therapist | 4720 Center Blvd Apt 3006, Long Island City, NY 11109-5648 | 2020-10-12 |
| 1891392940 | Dr Omolola Omishore Pt, P.C. | Physical Therapist | 1138 Ocean Ave Apt 6i, Brooklyn, NY 11230 | 2020-10-01 |
| 1912514704 | Hochung Jeon | Physical Therapist | 4545 Center Blvd Apt 904, Long Island City, NY 11109-5917 | 2020-09-25 |
| 1831704469 | Colleen M Brough | Physical Therapist | 710 W 168th St Ste 336, New York, NY 10032-3726 | 2020-09-10 |
| 1225641731 | Kyle Dillon | Physical Therapist | 667 Stoneleigh Ave Ste 11, Carmel, NY 10512-2454 | 2020-08-25 |
| 1346853033 | R.l. Physical Therapy | Physical Therapist | 1676 Putney Road, Valley Stream, NY 11580 | 2020-08-24 |
| 1194335059 | Donn Samson | Physical Therapist | 8762 52nd Ave Fl 2, Elmhurst, NY 11373-3938 | 2020-08-05 |
| 1679195499 | Vital Rehab LLC | Physical Therapist | 3165 Nostrand Ave Apt 4e, Brooklyn, NY 11229-3243 | 2020-05-14 |
| 1508485657 | Melvin Varghese | Physical Therapist | 172 Hoover Rd, Yonkers, NY 10710-3409 | 2020-04-09 |
| Find all providers with the same taxonomy | ||||
| City | STATEN ISLAND |
| Zip Code | 10314 |
Please comment or provide details below to improve the information on REVIVE PHYSICAL THERAPY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.