Provider Demographics
NPI:1669184883
Name:STRASSER-NICOL, CALEB ALEXANDER
Entity type:Individual
Prefix:MR
First Name:CALEB
Middle Name:ALEXANDER
Last Name:STRASSER-NICOL
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 1:13838 CASTLE BLVD APT 101
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-7381
Mailing Address - Country:US
Mailing Address - Phone:240-423-8631
Mailing Address - Fax:
Practice Address - Street 1:13838 CASTLE BLVD APT 101
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-7381
Practice Address - Country:US
Practice Address - Phone:240-423-8631
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty