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

Revolution Physical Therapy PLLC

Organization Physical Therapist · NPI 1689281842

Revolution Physical Therapy PLLC provides Physical Therapist services in New York, New York. Registered with an NPI since 2020.

In the registry since
2020
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

115 W 30th St Rm 502
New York, NY 10001-4074
Phone: (631) 213-2394
Fax: (212) 898-0470
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X

Record details

NPI number1689281842
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kenneth Van — Owner · (917) 816-0691
NPI enumeratedSeptember 30, 2020
Last updated in NPPESDecember 9, 2024
Certification dateDecember 9, 2024
Mailing address115 W 30th St Rm 502, New York, NY 10001-4074

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