REVIVE SPINE AND PAIN CENTER NPI 1235674912

NPI Information

  • NPI: 1235674912
  • Provider Name: REVIVE SPINE AND PAIN CENTER
  • Classification: Physical Medicine & Rehabilitation - 2081P2900X
  • Specialization: Pain Medicine
  • Entity Type: Organization
  • CLIA Number: 31D2133848
  • Address: 1001 LINCOLN DR W STE E
    MARLTON, NJ
    ZIP 08053
  • Phone: (856) 983-9001

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NPI Details

REVIVE SPINE AND PAIN CENTER is a pain medicine physical medicine rehabilitation in Marlton, NJ. The provider is a physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. REVIVE SPINE AND PAIN CENTER NPI is 1235674912. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1001 LINCOLN DR W STE E
MARLTON, NJ
ZIP 08053-534
Phone: (856) 983-9001
Fax: (856) 983-9011

The provider's authorized official is Mike Nammour .
The authorized official title is Manager and has the following contact phone number (856) 983-9001.

The CLIA number assigned to this NPI record is 31D2133848 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 1/4/2017 and was last updated on 1/31/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12081P2900XPhysical Medicine & RehabilitationPain MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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