| Nicole Kong, | |
|
4500 Satellite Blvd, Suite 2250, Duluth, GA 30096-5037 | |
| (800) 381-2195 | |
| Not Available |
| Full Name | Nicole Kong |
|---|---|
| Gender | Female |
| Speciality | Speech-language Pathologist |
| Location | 4500 Satellite Blvd, Duluth, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316492051 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 235Z00000X | Speech-language Pathologist | (* (Not Available)) | Primary |
| Provider Name | Northside Surgical Professional Services Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1356630990 PECOS PAC ID: 8628253424 Enrollment ID: O20110420000598 |
| Mailing Address | Practice Location Address |
|---|---|
| Nicole Kong, 4500 Satellite Blvd, Suite 2250, Duluth, GA 30096-5037 Ph: (800) 381-2195 | Nicole Kong, 4500 Satellite Blvd, Suite 2250, Duluth, GA 30096-5037 Ph: (800) 381-2195 |
Ashia N Fayne, M.S., CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 4500 Satellite Blvd, Duluth, GA 30096 Phone: 678-993-5122 | |
Mrs. Andrea Aubry, MS Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 3483 Satellite Blvd, Suite 304, Duluth, GA 30096 Phone: 770-418-1778 Fax: 770-418-1778 | |
Stephanie Nicole Brangwin, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 4855 River Green Pkwy Ste 610, Duluth, GA 30096 Phone: 470-499-1116 | |
Ms. Michele Barri Pliskin, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 3483 Satellite Blvd, Suite 304, Duluth, GA 30096 Phone: 770-418-1778 | |
Sydney Nicole Floyd, MACF-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 2845 Summercrest Ln, Duluth, GA 30096 Phone: 678-271-6978 Fax: 678-280-6766 | |
La'toya Williams, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1810 Peachtree Industrial Blvd Ste 231, Duluth, GA 30097 Phone: 678-505-0447 | |
Vanessa Risingmoon, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 4500 Satellite Blvd, Ste 2250, Duluth, GA 30096 Phone: 800-381-2195 Fax: 888-381-0822 |