Individual
MR. MACHCUONG HO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, APRN, FNP-BC/C
Contact information
Practice address
294 N MAIN ST, EAST LONGMEADOW, MA 01028-1838
(413) 224-1009
Mailing address
294 N MAIN ST STE 101, EAST LONGMEADOW, MA 01028-1879
(413) 224-1009
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN2334832
MA
363LP2300X
Primary Care Nurse Practitioner
000000
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN2334832
AESTHETIC MEDICINE, MENS HEALTH
MA
Enumeration date
08/16/2022
Last updated
11/29/2023
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