Provider Demographics
NPI:1174670525
Name:SKOUVAKIS, PAULETTE DIANE (DC)
Entity Type:Individual
Prefix:DR
First Name:PAULETTE
Middle Name:DIANE
Last Name:SKOUVAKIS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:PAULETTE
Other - Middle Name:DIANE
Other - Last Name:MATUSZEWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:1327 N WEST ST
Mailing Address - Street 2:WILMINGTON
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19801-1027
Mailing Address - Country:US
Mailing Address - Phone:267-844-0291
Mailing Address - Fax:302-475-2516
Practice Address - Street 1:1800 NAAMANS RD
Practice Address - Street 2:SUITE 1
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-2600
Practice Address - Country:US
Practice Address - Phone:302-475-3200
Practice Address - Fax:302-475-2516
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009626111NR0400X
NJ38MC00635700111NR0400X
DEF1-0000826111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NR0400XChiropractic ProvidersChiropractorRehabilitation