Healthcare Provider Details

I. General information

NPI: 1528987054
Provider Name (Legal Business Name): REVERSAL HEALTH AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3124 WILMINGTON RD STE 304
NEW CASTLE PA
16105-1100
US

IV. Provider business mailing address

3124 WILMINGTON RD STE 304
NEW CASTLE PA
16105-1100
US

V. Phone/Fax

Practice location:
  • Phone: 724-856-2122
  • Fax:
Mailing address:
  • Phone: 724-856-2122
  • Fax: 724-546-5141

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANTONIO FRANK REINO
Title or Position: MANAGING MEMBER
Credential: CRNP
Phone: 724-856-2122