Provider Demographics
NPI:1700655909
Name:ASONG, AMOH
Entity Type:Individual
Prefix:
First Name:AMOH
Middle Name:
Last Name:ASONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 LEE AVE APT 101
Mailing Address - Street 2:
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-4543
Mailing Address - Country:US
Mailing Address - Phone:240-653-0464
Mailing Address - Fax:
Practice Address - Street 1:26 LEE AVE APT 101
Practice Address - Street 2:
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-4543
Practice Address - Country:US
Practice Address - Phone:240-653-0464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-28
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide