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General NPI Number Information
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NPI Number | 1700393048
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Entity Type | Organization
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Legal Business Name | THE HUMAN PERFORMANCE MECHANIC
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Dates
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Enumeration Date | 01/09/2018
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Last Update Date | 01/09/2018
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Provider Practice Location Address
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Address Line | 370 LEXINGTON AVE
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City | NEW YORK
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State | NY
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Zip | 10017-6503
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Country | US
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Telephone | 914-400-3650
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Fax |
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Provider Business Mailing Address
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Address Line | 113 LEE RD
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City | SCARSDALE
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State | NY
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Zip | 10583-5229
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Country | US
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Telephone | 914-400-3650
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NICHOLAS ROLNICK
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Credential | DPT, MS
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Telephone | 914-400-3650
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 041648
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License Number State | NY
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