Revive Physical Therapy

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

17990 Issued in NY

Legal business name

REVIVE PHYSICAL THERAPY

Practice address

1330A Rockland Ave
Staten Island, NY 10314-4944

Phone

(718) 619-2259

NPI assigned

Nov 15, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Tory Badalamenti, PT

Title

President

Phone

(718) 619-2259

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1479168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479168000000",
    "number": "1548702079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 BIDWELL AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103143177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330A ROCKLAND AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103144944",
            "telephone_number": "718-619-2259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-15",
        "last_updated": "2016-11-15",
        "status": "A",
        "authorized_official_last_name": "BADALAMENTI",
        "authorized_official_first_name": "TORY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-619-2259",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NY",
            "license": "17990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George J Rettagliata, MD
• Lauren Reuter
• Samantha Revello, DO
• Veronica Revenco
• David Reves, O.D.
• Kelsey Rey
• Lilia Rey, SLP
• Brendaliz Reyes Arroyo
• Krystal Reyes Maffei
• Melina Reyes Vazquez

• Orthopedic Physical Therapist in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Orthopedic Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2016; 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.