Healthcare Provider Details

I. General information

NPI: 1518892678
Provider Name (Legal Business Name): PIVOT LIVESTYLE AND REHABILITATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

726 WILSON CT
RIVER VALE NJ
07675
US

IV. Provider business mailing address

726 WILSON CT
RIVER VALE NJ
07675
US

V. Phone/Fax

Practice location:
  • Phone: 917-497-5866
  • Fax:
Mailing address:
  • Phone: 917-497-5866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MARIA MOLDOVAN
Title or Position: BOARD CERTIFIED DPT BOARD CERTIFIED
Credential: DPT, DIPACLM
Phone: 917-497-5866