Revivify LLC
NPI #1063172880 in Summit, New Jersey
Provider Information
- NPI Number
- 1063172880
- Entity Type
- Organization
- Organization Name
- Revivify LLC
- Primary Specialty
- Physical Medicine & Rehabilitation - Pain Medicine
- Enumeration Date
- Dec 20, 2021
- Last Updated
- Dec 20, 2021
Practice Location
- Address
- 68 RIVER ROAD
- Address 2
- ANNEX
- City
- Summit
- State
- New Jersey
- ZIP Code
- 07901-1450
- Phone
- (908) 273-2222
Authorized Official
- Name
- MARCO DIMAYORCA, PARAMEDIC
- Title
- MANAGING MEMBER
- Phone
- (908) 273-2222
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physical Medicine & Rehabilitation - Pain Medicine — Pain Medicine |
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