MEDICARE: PERFORMANCERX NUTRITION & FITNESS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1194678847
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PERFORMANCERX NUTRITION & FITNESS

Provider Business Mailing Address
First Line	:	569 S BRADDOCK AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15221-3216
Country	:	US
Telephone Number	:	570-862-5895
Fax Number	:

Provider Business Practice Location Address
First Line	:	569 S BRADDOCK AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15221-3216
Country	:	US
Telephone Number	:	570-862-5895
Fax Number	:

Authorized Official
Title or Position	:	REGISTERED DIETITIAN
Name	:	TING AN FANG
Credential	:	RDN, CDCES
Telephone Number	:	570-862-5895

Provider Enumeration Date	:	02/20/2026
Last Update Date	:	02/20/2026

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