Provider Demographics
NPI:1558105270
Name:LOING, EDWARD FREDO
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:FREDO
Last Name:LOING
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 1:5998 DEBATE WAY
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:OH
Mailing Address - Zip Code:43119-8262
Mailing Address - Country:US
Mailing Address - Phone:206-601-8292
Mailing Address - Fax:
Practice Address - Street 1:5998 DEBATE WAY
Practice Address - Street 2:
Practice Address - City:GALLOWAY
Practice Address - State:OH
Practice Address - Zip Code:43119-8262
Practice Address - Country:US
Practice Address - Phone:206-601-8292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-19
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty