Revive Pharmacy Inc

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

REVIVE PHARMACY INC

Practice address

917 Ogden Ave
Bronx, NY 10452-5547

Phone

(718) 618-5190

NPI assigned

Nov 5, 2024

Organization subpart

No

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

Authorized official

Name

Ziad Gamal Abdelnabi

Title

Owner

Phone

(973) 449-0091

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1730764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777248000000",
    "number": "1740003052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "917 OGDEN AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104525547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "917 OGDEN AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104525547",
            "telephone_number": "718-618-5190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-05",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A",
        "authorized_official_last_name": "ABDELNABI",
        "authorized_official_first_name": "ZIAD",
        "authorized_official_middle_name": "GAMAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-449-0091"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaclyn Rose Rettig, ATC
• Samantha Reuter, PA
• Josef Reutershan, BSW
• Sofia Marie Reverendo, LMSW
• Revival Physical Therapy & Rehabilitation Services, PC
• Revive Psycho Therapy LLC
• Revolution Medical Supply
• Stephanie Lynn Revoredo
• Rex Medical P.C.
• Taina Belen Rexach

• Pharmacy in Bronx, NY
• Providers in Bronx, NY by specialty
• Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.