| Organization Name: | REVOLUTIONARY PHYSICAL THERAPY INC. |
| NPI Number: | 1578813994 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DANIEL MERCADO (OWNER/PRESIDENT) |
| Mailing Address: | 60 Garden St Little Ferry |
| State: | NJ US |
| Postal Code: | 076431535 |
| Phone Number: | 2016676971 |
| Fax Number: | |
| NPI Enumeration Date: | 09/12/2012 |
| NPI Last Update Date: | 09/12/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 40QA00805300 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |