Provider Demographics
NPI:1609677137
Name:LY, OUMAR
Entity type:Individual
Prefix:
First Name:OUMAR
Middle Name:
Last Name:LY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1775 ELTON RD
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20903-1757
Mailing Address - Country:US
Mailing Address - Phone:513-386-8251
Mailing Address - Fax:
Practice Address - Street 1:1775 ELTON RD
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20903-1757
Practice Address - Country:US
Practice Address - Phone:513-386-8251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-21
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter