Provider Demographics
NPI:1942630694
Name:IBRAHIM, NAJIBA
Entity Type:Individual
Prefix:
First Name:NAJIBA
Middle Name:
Last Name:IBRAHIM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1766 COLUMBIA RD NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-2814
Mailing Address - Country:US
Mailing Address - Phone:202-483-0208
Mailing Address - Fax:202-483-0129
Practice Address - Street 1:1766 COLUMBIA RD NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-2814
Practice Address - Country:US
Practice Address - Phone:202-483-0208
Practice Address - Fax:202-483-0129
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-16
Last Update Date:2013-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCOP465152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist