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General NPI Number Information
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NPI Number | 1265356935
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Entity Type | Organization
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Legal Business Name | REVIVE MEDTECH LLC
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Dates
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Enumeration Date | 08/06/2026
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Last Update Date | 08/06/2026
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Provider Practice Location Address
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Address Line | 555 BROADHOLLOW RD STE 305
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City | MELVILLE
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State | NY
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Zip | 11747-5018
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Country | US
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Telephone | 631-759-5655
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Fax | 631-759-5655
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Provider Business Mailing Address
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Address Line | 555 BROADHOLLOW RD STE 305
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City | MELVILLE
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State | NY
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Zip | 11747-5018
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Country | US
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Telephone | 631-759-5655
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Fax | 631-759-5655
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Authorized Official
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Title or Position | MANAGER
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Name | SANJEEV KUMAR
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Credential |
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Telephone | 631-759-5655
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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