1316645179 NPI number — NICOLE A WADHWA-SCHIFF DAC., LAC.

Table of content: NICOLE A WADHWA-SCHIFF DAC., LAC. (NPI 1316645179)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316645179 NPI number — NICOLE A WADHWA-SCHIFF DAC., LAC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WADHWA-SCHIFF
Provider First Name:
NICOLE
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DAC., LAC.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WADHWA
Provider Other First Name:
NICOLE
Provider Other Middle Name:
A
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
DAC., LAC.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1316645179
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/21/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
75-5526 KEALIA ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOLUALOA
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96725-9613
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-938-7473
Provider Business Mailing Address Fax Number:
808-333-5541

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
75-5995 KUAKINI HWY STE 602
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KAILUA KONA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96740-2124
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-938-7473
Provider Business Practice Location Address Fax Number:
808-333-5541
Provider Enumeration Date:
02/21/2023

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 171100000X , with the licence number:  ACU-1393 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 006785 . This is a "THE UNIVERSITY OF THE STATE OF NEW YORK EDUCATION DEPARTMENT" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: ACU-1393 . This is a "DEPARTMENT OF COMMERCE & CONSUMER AFFAIRS PROFESSIONAL VOCATIONAL LICENSING" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 845203 . This is a "NATIONAL CERTIFICATION COMMISSION FOR ACUPUNCTURE AND ORIENTAL MEDICINE (NCCAOM)" identifier . This identifiers is of the category "OTHER".




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