Provider Demographics
NPI:1598770208
Name:TRIANDOS, NICK (DC)
Entity Type:Individual
Prefix:DR
First Name:NICK
Middle Name:
Last Name:TRIANDOS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 N WASHINGTON ST
Mailing Address - Street 2:# 710
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-2530
Mailing Address - Country:US
Mailing Address - Phone:703-548-5600
Mailing Address - Fax:
Practice Address - Street 1:300 N WASHINGTON ST
Practice Address - Street 2:# 710
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-2530
Practice Address - Country:US
Practice Address - Phone:703-548-5600
Practice Address - Fax:703-548-6484
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02006111NS0005X
VA0104001977111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA490176Medicare ID - Type Unspecified