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

Mr. Rene Revillas

Individual provider Physical Therapist · NPI 1639563737

Mr. Rene Revillas is a Physical Therapist in Kew Gardens, New York. Practices as a sole proprietor. Licensed in California, Hawaii and New York.

Licensed in
CA, HI, NY
In the registry since
2015
Specialties on file
3
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Practice location Address checks out

8441 130th St
Kew Gardens, NY 11415-2812
Phone: (315) 561-1817
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 42048 (CA)
Physical Therapist Taxonomy 225100000X · Licence 031838 (NY)
Physical Therapist Taxonomy 225100000X · Licence 3946 (HI)

Record details

NPI number1639563737
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMarch 26, 2015
Last updated in NPPESMarch 26, 2015

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