Healthcare Provider Details

I. General information

NPI: 1326716739
Provider Name (Legal Business Name): NICHOLAS ROBERT FINELLI PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2021
Last Update Date: 09/02/2021
Certification Date: 09/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 K ST NW STE 750
WASHINGTON DC
20006-1023
US

IV. Provider business mailing address

850 N RANDOLPH ST APT 1407
ARLINGTON VA
22203-4019
US

V. Phone/Fax

Practice location:
  • Phone: 202-293-1853
  • Fax:
Mailing address:
  • Phone: 757-818-5404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305214680
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: