Provider Demographics
NPI:1952746612
Name:STRASSER-NICOL, ELIZABETH D IV
Entity Type:Individual
Prefix:MISS
First Name:ELIZABETH
Middle Name:D
Last Name:STRASSER-NICOL
Suffix:IV
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 1:790 FAIRVIEW AVE APT 415
Mailing Address - Street 2:415
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-5959
Mailing Address - Country:US
Mailing Address - Phone:910-429-6737
Mailing Address - Fax:
Practice Address - Street 1:790 FAIRVIEW AVE APT 415
Practice Address - Street 2:415
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-5959
Practice Address - Country:US
Practice Address - Phone:910-429-6737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-07
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health