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General NPI Number Information
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NPI Number | 1831952555
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Entity Type | Organization
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Legal Business Name | AVIVA LLC
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Dates
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Enumeration Date | 02/05/2024
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Last Update Date | 10/31/2024
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Provider Practice Location Address
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Address Line | 99-209 MOANALUA RD STE 314
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City | AIEA
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State | HI
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Zip | 96701-4042
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Country | US
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Telephone | 808-797-8721
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Fax |
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Provider Business Mailing Address
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Address Line | 5909 GANNET AVE # B
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City | EWA BEACH
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State | HI
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Zip | 96706-3211
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Country | US
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Telephone | 808-797-8721
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MISS MELISSA PULICICCHIO
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Credential | LICENSED ACUPUNCTURI
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Telephone | 808-797-8721
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QB0400X
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Taxonomy Name | Birthing Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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