Provider Demographics
NPI:1619152105
Name:NEIL R. OHORA
Entity Type:Organization
Organization Name:NEIL R. OHORA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR. OHORA
Authorized Official - Prefix:
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:R
Authorized Official - Last Name:OHORA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:301-774-1200
Mailing Address - Street 1:18111 PRINCE PHILLIP DR
Mailing Address - Street 2:SUITE 212
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:18111 PRINCE PHILLIP DR
Practice Address - Street 2:SUITE 212
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832
Practice Address - Country:US
Practice Address - Phone:301-774-1200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-03
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD0995332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
T31276Medicare UPIN
DC1066100001Medicare NSC