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General NPI Number Information
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NPI Number | 1275457038
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Entity Type | Organization
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Legal Business Name | REVIVE MEDICAL GROUP PC
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Dates
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Enumeration Date | 08/05/2026
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Last Update Date | 08/05/2026
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Provider Practice Location Address
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Address Line | 1136 CLIFTON AVE FL 1
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City | CLIFTON
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State | NJ
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Zip | 07013-3622
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Country | US
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Telephone | 862-249-1266
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Fax | 201-984-2185
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Provider Business Mailing Address
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Address Line | 468 W SADDLE RIVER RD
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City | UPPER SADDLE RIVER
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State | NJ
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Zip | 07458-1626
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Country | US
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Telephone | 551-486-1385
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Fax | 201-984-2185
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MUHAMMAD FARHAN IJAZ
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Credential | MD
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Telephone | 551-486-1385
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NX0800X
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Taxonomy Name | Orthopedic Chiropractor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207XX0004X
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Taxonomy Name | Orthopaedic Foot and Ankle Surgery Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 2083A0300X
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Taxonomy Name | Addiction Medicine (Preventive Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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