Restoralive LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

RESTORALIVE LLC

Practice address

19 Sherman CT
New Haven, CT 06511-4303

Phone

(203) 460-0665

NPI assigned

Jan 23, 2023

Organization subpart

No

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

Authorized official

Name

Darrell Nurse, DPT

Title

Member

Phone

(203) 460-0665

Specialties & licenses 1

Addresses

Other names 1

• Restoralive Doing business as

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

{
    "created_epoch": "1674432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674432000000",
    "number": "1093420135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 SHERMAN CT",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065114303",
            "telephone_number": "203-460-0665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 SHERMAN CT",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065114303",
            "telephone_number": "203-460-0665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORALIVE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-23",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A",
        "authorized_official_last_name": "NURSE",
        "authorized_official_first_name": "DARRELL",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "203-460-0665",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Restoralive",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Erica Reshard, LADC, MSW
• Benjamin Resio
• Stephanie Resnick
• Michael J Rest, MD
• Richard Joseph Restifo, MD
• Valentina Restrepo Espinosa, MD
• Jose Restrepo, M.D.
• Alba Yessenia Reveron
• Revive Wellness Center, LLC
• Rebecca Revzin, FNP-C

• Physical Therapist in New Haven, CT
• Providers in New Haven, CT by specialty
• Physical Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2023; 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.