Provider Demographics
NPI:1780406645
Name:PADULA, NYKOS VOHN
Entity type:Individual
Prefix:
First Name:NYKOS
Middle Name:VOHN
Last Name:PADULA
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 1:1505 CRYSTAL DR APT 705
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22202-4170
Mailing Address - Country:US
Mailing Address - Phone:612-226-6784
Mailing Address - Fax:
Practice Address - Street 1:1517 18TH ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-1305
Practice Address - Country:US
Practice Address - Phone:202-344-0065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-30
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator