Healthcare Provider Details

I. General information

NPI: 1992719694
Provider Name (Legal Business Name): METINEE SARASUP STRICKLAND P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 10/20/2023
Certification Date: 10/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5801 ARMY PENTAGON CORRIDOR 8, ROOM 110
WASHINGTON DC
20310-2040
US

IV. Provider business mailing address

5801 ARMY PENTAGON CORRIDOR 8, ROOM 110
WASHINGTON DC
20310-0001
US

V. Phone/Fax

Practice location:
  • Phone: 703-692-8849
  • Fax: 703-692-6250
Mailing address:
  • Phone: 703-692-8849
  • Fax: 703-692-6250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110001410
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: