Provider Demographics
NPI:1275108870
Name:SABUM, VALERY M
Entity Type:Individual
Prefix:
First Name:VALERY
Middle Name:M
Last Name:SABUM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 IRVING ST NE APT 104
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20018-2444
Mailing Address - Country:US
Mailing Address - Phone:202-415-1371
Mailing Address - Fax:
Practice Address - Street 1:880 SOUTHERN AVE SE APT 304
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-3437
Practice Address - Country:US
Practice Address - Phone:202-520-0873
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-25
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant