Healthcare Provider Details

I. General information

NPI: 1467336180
Provider Name (Legal Business Name): NICOLETA PANAITE PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2025
Last Update Date: 11/02/2025
Certification Date: 11/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SUDLAGER 301
VILSECK BAVARIA
92249
DE

IV. Provider business mailing address

PSC 411 BOX 5409
APO AE
09112-0055
US

V. Phone/Fax

Practice location:
  • Phone: 15-150-9082
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: