Provider Demographics
NPI:1073987954
Name:BARRY, MOHAMED S (CRNP-FNP)
Entity Type:Individual
Prefix:MR
First Name:MOHAMED
Middle Name:S
Last Name:BARRY
Suffix:
Gender:M
Credentials:CRNP-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:799 ROCKVILLE PIKE
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-1136
Mailing Address - Country:US
Mailing Address - Phone:301-340-2683
Mailing Address - Fax:
Practice Address - Street 1:799 ROCKVILLE PIKE
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-1136
Practice Address - Country:US
Practice Address - Phone:301-340-2683
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-16
Last Update Date:2018-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDRN168133363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily