Healthcare Provider Details

I. General information

NPI: 1396944567
Provider Name (Legal Business Name): SINA J. SABET MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2007
Last Update Date: 07/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5130 DUKE STREET SUITE 9
ALEXANDRIA VA
22304-2955
US

IV. Provider business mailing address

5130 DUKE STREET SUITE 9
ALEXANDRIA VA
22304-2955
US

V. Phone/Fax

Practice location:
  • Phone: 703-370-9411
  • Fax: 703-370-9417
Mailing address:
  • Phone: 703-370-9411
  • Fax: 703-370-9417

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number010105674
License Number StateVA

VIII. Authorized Official

Name: SINA JOHN SABET
Title or Position: PRESIDENT
Credential: MD
Phone: 703-370-9411