# REVIVE MEDICAL GROUP PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275457038
- **Authorized official:** DR. MUHAMMAD FARHAN IJAZ MD (PRESIDENT)
- **Authorized official phone:** (551) 486-1385

## Contact information

- **Practice address:** 1136 CLIFTON AVE FL 1, CLIFTON, NJ 07013-3622
- **Practice address phone:** (862) 249-1266
- **Practice address fax:** (201) 984-2185
- **Mailing address:** 468 W SADDLE RIVER RD, UPPER SADDLE RIVER, NJ 07458-1626
- **Mailing address phone:** (551) 486-1385
- **Mailing address fax:** (201) 984-2185

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111NX0800X | Orthopedic Chiropractor | — | NULL | — |
| 111NX0800X | Orthopedic Chiropractor | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |
| 207XS0117X | Orthopaedic Surgery of the Spine Physician | — | NULL | — |
| 207XS0117X | Orthopaedic Surgery of the Spine Physician | — | — | — |
| 207XX0004X | Orthopaedic Foot and Ankle Surgery Physician | — | NULL | — |
| 207XX0004X | Orthopaedic Foot and Ankle Surgery Physician | — | — | — |
| 2083A0300X | Addiction Medicine (Preventive Medicine) Physician | — | NULL | — |
| 2083A0300X | Addiction Medicine (Preventive Medicine) Physician | — | — | — |
| 2084N0400X | Neurology Physician | — | NULL | — |
| 2084N0400X | Neurology Physician | — | — | — |
| 2086S0129X | Vascular Surgery Physician | — | NULL | — |
| 2086S0129X | Vascular Surgery Physician | — | — | — |

## Other

- **Enumeration date:** 08/05/2026
- **Last updated:** 08/05/2026