Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Revive Spine and Pain Center

Organization Sports Medicine (Physical Medicine & Rehabilitation) Physician · NPI 1457896003

Revive Spine and Pain Center is a Sports Medicine (Physical Medicine & Rehabilitation) Physician in Marlton, New Jersey. Works from 3 locations. Licensed in New Jersey.

Licensed in
NJ
In the registry since
2017
Specialties on file
2

Practice location Address checks out

1001 Lincoln Dr W Ste E
Marlton, NJ 08053-1534
Phone: (856) 983-9001
Fax: (856) 983-9011
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 555 Route 18 Ste 201, East Brunswick, NJ 08816-3727 — (732) 955-9139
  • 1245 Whitehorse Mercerville Rd Ste 407, Hamilton, NJ 08619-3831 — (609) 581-2400

Specialties & licences

Sports Medicine (Physical Medicine & Rehabilitation) Physician (primary) Taxonomy 2081S0010X
Pain Clinic/Center Taxonomy 261QP3300X · Licence 25MA08922900 (NJ)

Record details

NPI number1457896003
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michael Rizkalla — Director · (856) 983-9001
NPI enumeratedJanuary 5, 2017
Last updated in NPPESJanuary 31, 2024
Certification dateJanuary 31, 2024
Mailing addressPo Box 1126, Absecon, NJ 08201

Other providers in Marlton