Provider Demographics
NPI:1053910083
Name:LING, NICOLE WING SZE (RDN)
Entity type:Individual
Prefix:
First Name:NICOLE WING SZE
Middle Name:
Last Name:LING
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:448 HOWARD ST
Mailing Address - Street 2:
Mailing Address - City:NORTHBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01532-1000
Mailing Address - Country:US
Mailing Address - Phone:413-427-0751
Mailing Address - Fax:
Practice Address - Street 1:448 HOWARD ST
Practice Address - Street 2:
Practice Address - City:NORTHBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01532-1000
Practice Address - Country:US
Practice Address - Phone:413-427-0751
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-21
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5148-NU-NU133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered