Provider Demographics
NPI:1831937481
Name:ISSA, GILGAL SARSAR
Entity type:Individual
Prefix:
First Name:GILGAL
Middle Name:SARSAR
Last Name:ISSA
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 1:5507 SMITA PL
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2475
Mailing Address - Country:US
Mailing Address - Phone:240-854-9660
Mailing Address - Fax:
Practice Address - Street 1:5507 SMITA PL
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-2475
Practice Address - Country:US
Practice Address - Phone:240-854-9660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-17
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator