Provider Demographics
NPI:1225631971
Name:AKRAWI, LEALAV
Entity Type:Individual
Prefix:
First Name:LEALAV
Middle Name:
Last Name:AKRAWI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6866 FRASE DR
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22043-3066
Mailing Address - Country:US
Mailing Address - Phone:571-331-4975
Mailing Address - Fax:
Practice Address - Street 1:GIANT 0758
Practice Address - Street 2:1454 CHAIN BRIDGE RD
Practice Address - City:MCLEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-2210
Practice Address - Country:US
Practice Address - Phone:703-893-8593
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202205220183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist