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General NPI Number Information
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NPI Number | 1750263802
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Entity Type | Organization
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Legal Business Name | MASSAGE EVOLUTION P.C.
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Dates
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Enumeration Date | 07/21/2025
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Last Update Date | 07/21/2025
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Provider Practice Location Address
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Address Line | 415 W 57TH ST STE BC
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City | NEW YORK
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State | NY
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Zip | 10019-1752
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Country | US
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Telephone | 646-285-4952
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Fax |
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Provider Business Mailing Address
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Address Line | 2000 W FORT LEE RD APT 2215
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City | BOGOTA
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State | NJ
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Zip | 07603-1549
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Country | US
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Telephone | 646-285-4952
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. HOWARD STEPHEN MERMELSTEIN
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Credential | LMT
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Telephone | 646-285-4952
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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