Provider Demographics
NPI:1952856700
Name:OMAR, HAFEEZAH (OD)
Entity Type:Individual
Prefix:DR
First Name:HAFEEZAH
Middle Name:
Last Name:OMAR
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1950 OLD GALLOWS RD STE 520
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3970
Mailing Address - Country:US
Mailing Address - Phone:703-847-8899
Mailing Address - Fax:571-223-6780
Practice Address - Street 1:6178 OXON HILL RD STE 100
Practice Address - Street 2:
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-3161
Practice Address - Country:US
Practice Address - Phone:301-839-5555
Practice Address - Fax:301-839-1867
Is Sole Proprietor?:No
Enumeration Date:2016-08-22
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2495152W00000X
VA0618002517152W00000X
MDTA2574152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist