Provider Demographics
NPI:1295201648
Name:DAHER, OMAR
Entity type:Individual
Prefix:
First Name:OMAR
Middle Name:
Last Name:DAHER
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 1:3701 S GEORGE MASON DR UNIT 2005N
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22041-3712
Mailing Address - Country:US
Mailing Address - Phone:571-213-9962
Mailing Address - Fax:
Practice Address - Street 1:7535 LITTLE RIVER TPKE STE 310D
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-2989
Practice Address - Country:US
Practice Address - Phone:571-213-9962
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-23
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant