Healthcare Provider Details

I. General information

NPI: 1174670525
Provider Name (Legal Business Name): PAULETTE DIANE SKOUVAKIS D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PAULETTE DIANE MATUSZEWSKI D.C.

II. Dates (important events)

Enumeration Date: 01/05/2007
Last Update Date: 05/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 NAAMANS RD SUITE 1
WILMINGTON DE
19810-2600
US

IV. Provider business mailing address

1327 N WEST ST WILMINGTON
WILMINGTON DE
19801-1027
US

V. Phone/Fax

Practice location:
  • Phone: 302-475-3200
  • Fax: 302-475-2516
Mailing address:
  • Phone: 267-844-0291
  • Fax: 302-475-2516

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberDC009626
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number38MC00635700
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberF1-0000826
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: