Provider Demographics
NPI:1811695844
Name:SAVAIINAEA, NIKOLAO MIKAELE
Entity type:Individual
Prefix:
First Name:NIKOLAO
Middle Name:MIKAELE
Last Name:SAVAIINAEA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3605 WINDING WAY
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19073-4057
Mailing Address - Country:US
Mailing Address - Phone:610-325-6037
Mailing Address - Fax:
Practice Address - Street 1:3605 WINDING WAY
Practice Address - Street 2:
Practice Address - City:NEWTOWN SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19073-4057
Practice Address - Country:US
Practice Address - Phone:610-325-6037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-20
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC011820111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PADC011820OtherNO NUMBER YET