Basic Information
Provider Information
NPI: 1639844095
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ASSAR
FirstName: AHMED
MiddleName: HANI
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2150 PENNSYLVANIA AVE NW
Address2:  
City: WASHINGTON
State: DC
PostalCode: 200373201
CountryCode: US
TelephoneNumber: 2027413000
FaxNumber:  
Practice Location
Address1: 3300 GALLOWS RD DEPT OF
Address2:  
City: FALLS CHURCH
State: VA
PostalCode: 220423300
CountryCode: US
TelephoneNumber: 7037763626
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/09/2021
LastUpdateDate: 08/09/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/09/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0015X0116036020VAN Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychosomatic Medicine
390200000X0116036020VAY Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


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