Provider Demographics
NPI:1457585994
Name:HO-SANG, NICOLE LEONIE (CSA)
Entity type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:LEONIE
Last Name:HO-SANG
Suffix:
Gender:F
Credentials:CSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8205 MARSHALL CORNER RD STE 52
Mailing Address - Street 2:
Mailing Address - City:POMFRET
Mailing Address - State:MD
Mailing Address - Zip Code:20675-3200
Mailing Address - Country:US
Mailing Address - Phone:240-355-1725
Mailing Address - Fax:
Practice Address - Street 1:8205 MARSHALL CORNER RD STE 52
Practice Address - Street 2:
Practice Address - City:POMFRET
Practice Address - State:MD
Practice Address - Zip Code:20675-3200
Practice Address - Country:US
Practice Address - Phone:240-355-1725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-12
Last Update Date:2024-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
246ZC0007X
VA2933246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant