Omar Ragheb Assaly

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

390200000X Issued in OH

Practice address

3640 Colonel Glenn Hwy
Dayton, OH 45435-0002

Phone

(937) 775-3458

NPI assigned

Aug 22, 2021

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1629590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629590400000",
    "number": "1487320115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6710 VICTORIA CT",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435603293",
            "telephone_number": "567-249-9437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3640 COLONEL GLENN HWY",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454350002",
            "telephone_number": "937-775-3458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASSALY",
        "first_name": "OMAR",
        "middle_name": "RAGHEB",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-22",
        "last_updated": "2021-08-22",
        "certification_date": "2021-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": "390200000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Student in an Organized Health Care Education/Training Program in Dayton, OH
• Providers in Dayton, OH by specialty
• Student in an Organized Health Care Education/Training Program in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.