Provider Demographics
NPI:1316608532
Name:WARRAICH, MOMAN
Entity type:Individual
Prefix:
First Name:MOMAN
Middle Name:
Last Name:WARRAICH
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 1:14502 GREENVIEW DR STE 500
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-4245
Mailing Address - Country:US
Mailing Address - Phone:202-670-6447
Mailing Address - Fax:
Practice Address - Street 1:14502 GREENVIEW DR STE 500
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-4245
Practice Address - Country:US
Practice Address - Phone:202-670-6447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-10
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other