Provider Demographics
NPI:1760504534
Name:ROLNICK, ELEANOR L (DC)
Entity Type:Individual
Prefix:DR
First Name:ELEANOR
Middle Name:L
Last Name:ROLNICK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 ALFRED ST
Mailing Address - Street 2:
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-3742
Mailing Address - Country:US
Mailing Address - Phone:207-283-1168
Mailing Address - Fax:
Practice Address - Street 1:413 ALFRED ST
Practice Address - Street 2:
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005-3742
Practice Address - Country:US
Practice Address - Phone:207-283-1168
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR554111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME000469OtherANTHEM
MET31644Medicare UPIN
MERO MM9784Medicare ID - Type Unspecified