Healthcare Provider Details

I. General information

NPI: 1912842204
Provider Name (Legal Business Name): IBRAHIM TURAY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1516 WYNCOTE CIR
SEVERN MD
21144-3432
US

IV. Provider business mailing address

1516 WYNCOTE CIR
SEVERN MD
21144-3432
US

V. Phone/Fax

Practice location:
  • Phone: 703-431-4404
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA200006098
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: