Revive Bodyworks

Primary specialty

Massage TherapistTaxonomy code 225700000X

Legal business name

REVIVE BODYWORKS

Practice address

523 Townline Rd Ste 7
Hauppauge, NY 11788-2827

Phone

(631) 943-1243

NPI assigned

Mar 3, 2022

Last updated

Mar 3, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Paula Kolano, LMTNPI 1215573696

Title

Owner

Phone

(631) 943-1243

Specialties & licenses 1

Addresses

Other names 1

• Revive Bodyworks Corp Former legal business name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Paula Kolano, LMT

  • Massage Therapist
  • Hauppauge, NY
  • NPI 1215573696
  NPD Authorized official

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

{
    "created_epoch": "1646265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646265600000",
    "number": "1275280943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 DOLPHIN LN",
            "city": "WEST BABYLON",
            "state": "NY",
            "postal_code": "117048504",
            "telephone_number": "631-943-1243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "523 TOWNLINE RD STE 7",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117882827",
            "telephone_number": "631-943-1243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE BODYWORKS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-03",
        "last_updated": "2022-03-03",
        "certification_date": "2022-03-03",
        "status": "A",
        "authorized_official_last_name": "KOLANO",
        "authorized_official_first_name": "PAULA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-943-1243",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Revive Bodyworks Corp",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Phyllis L Reischmann, PT
• Danielle Dolores Relyea, LMSW
• Steven B Ressel, O.D.
• Zulma Restituto
• Carolyn Patricia Reuter, OTR/L
• Dana Reyes
• Kevin Rich, NP
• Mary Puanani Rigney
• Amber Rijos, MA, CCC-SLP
• Meghan Riley-Beska

• Massage Therapist in Hauppauge, NY
• Providers in Hauppauge, NY by specialty
• Massage Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2022; 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.