Provider Demographics
NPI:1629855127
Name:VIROLA, NIKO SEBASTIANO
Entity Type:Individual
Prefix:
First Name:NIKO
Middle Name:SEBASTIANO
Last Name:VIROLA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 SPANGLER RD NE
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44714-1608
Mailing Address - Country:US
Mailing Address - Phone:740-433-9811
Mailing Address - Fax:
Practice Address - Street 1:124 SPANGLER RD NE
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44714-1608
Practice Address - Country:US
Practice Address - Phone:740-433-9811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide