Provider Demographics
NPI:1316645179
Name:WADHWA-SCHIFF, NICOLE A (DAC, LAC)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:A
Last Name:WADHWA-SCHIFF
Suffix:
Gender:F
Credentials:DAC, LAC
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:A
Other - Last Name:WADHWA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DAC, LAC
Mailing Address - Street 1:75-5526 KEALIA ST
Mailing Address - Street 2:
Mailing Address - City:HOLUALOA
Mailing Address - State:HI
Mailing Address - Zip Code:96725-9613
Mailing Address - Country:US
Mailing Address - Phone:808-938-7473
Mailing Address - Fax:808-333-5541
Practice Address - Street 1:75-5995 KUAKINI HWY STE 602
Practice Address - Street 2:
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-2124
Practice Address - Country:US
Practice Address - Phone:808-938-7473
Practice Address - Fax:808-333-5541
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-21
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIACU-1393171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY006785OtherTHE UNIVERSITY OF THE STATE OF NEW YORK EDUCATION DEPARTMENT
HIACU-1393OtherDEPARTMENT OF COMMERCE & CONSUMER AFFAIRS PROFESSIONAL VOCATIONAL LICENSING
845203OtherNATIONAL CERTIFICATION COMMISSION FOR ACUPUNCTURE AND ORIENTAL MEDICINE (NCCAOM)