Healthcare Provider Details

I. General information

NPI: 1942967625
Provider Name (Legal Business Name): FAISAL ABDULLAH LSA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2021
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5255 LOUGHBORO RD NW
WASHINGTON DC
20016-2696
US

IV. Provider business mailing address

5255 LOUGHBORO RD NW
WASHINGTON DC
20016-2696
US

V. Phone/Fax

Practice location:
  • Phone: 202-537-4000
  • Fax:
Mailing address:
  • Phone: 202-537-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License NumberSA0227
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: