Healthcare Provider Details

I. General information

NPI: 1063528040
Provider Name (Legal Business Name): NILOOFAR ARBABI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 07/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1760 RESTON PKWY SUITE 400
RESTON VA
20190-3388
US

IV. Provider business mailing address

7412 GEORGETOWN CT
MC LEAN VA
22102-2123
US

V. Phone/Fax

Practice location:
  • Phone: 703-467-9444
  • Fax: 703-467-8484
Mailing address:
  • Phone: 703-346-1510
  • Fax: 703-848-4652

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101235758
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: