Provider Demographics
NPI:1265059455
Name:PVA KNOWLEDGE GROUP LLC
Entity type:Organization
Organization Name:PVA KNOWLEDGE GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:DONNEL
Authorized Official - Last Name:NUNES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:808-554-6509
Mailing Address - Street 1:539 PAULELE ST
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-3547
Mailing Address - Country:US
Mailing Address - Phone:808-554-6509
Mailing Address - Fax:
Practice Address - Street 1:539 PAULELE ST
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-3547
Practice Address - Country:US
Practice Address - Phone:
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-03
Last Update Date:2020-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health