Provider Demographics
NPI:1992093769
Name:TANCHEFF, NICHOLAS MARK (DC)
Entity type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:MARK
Last Name:TANCHEFF
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:68-1749 HOOHIKI PL
Mailing Address - Street 2:
Mailing Address - City:WAIKOLOA
Mailing Address - State:HI
Mailing Address - Zip Code:96738-5105
Mailing Address - Country:US
Mailing Address - Phone:808-209-8002
Mailing Address - Fax:440-212-7006
Practice Address - Street 1:68-1820 WAIKOLOA RD STE 501
Practice Address - Street 2:
Practice Address - City:WAIKOLOA
Practice Address - State:HI
Practice Address - Zip Code:96738-5597
Practice Address - Country:US
Practice Address - Phone:808-209-8002
Practice Address - Fax:440-212-7006
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-14
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1216111N00000X
HIDC-1216111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor