Healthcare Provider Details

I. General information

NPI: 1194068577
Provider Name (Legal Business Name): KRAIDY & ALKAFFAF, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2013
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6801 BACKLICK RD STE A
SPRINGFIELD VA
22150-3071
US

IV. Provider business mailing address

6801 BACKLICK RD STE A
SPRINGFIELD VA
22150-3071
US

V. Phone/Fax

Practice location:
  • Phone: 202-352-7305
  • Fax:
Mailing address:
  • Phone: 202-352-7305
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number010236776
License Number StateVA

VIII. Authorized Official

Name: DR. ABDULKAREEM I KRAIDY
Title or Position: OWNER
Credential: M.D.
Phone: 517-575-3653