Healthcare Provider Details

I. General information

NPI: 1619713567
Provider Name (Legal Business Name): GERALD J SABB
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2024
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 ATLANTIC ST SW
WASHINGTON DC
20032-2350
US

IV. Provider business mailing address

4 ATLANTIC ST SW
WASHINGTON DC
20032-2350
US

V. Phone/Fax

Practice location:
  • Phone: 202-470-3080
  • Fax: 202-232-8494
Mailing address:
  • Phone: 202-470-3080
  • Fax: 202-232-8494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP1008451
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: