Provider Demographics
NPI:1275988982
Name:SAAB, RAISA (MD)
Entity Type:Individual
Prefix:
First Name:RAISA
Middle Name:
Last Name:SAAB
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1776 PAISLEY CT
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-5603
Mailing Address - Country:US
Mailing Address - Phone:703-405-0260
Mailing Address - Fax:
Practice Address - Street 1:8051 SUDLEY RD
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20109-8001
Practice Address - Country:US
Practice Address - Phone:703-531-3100
Practice Address - Fax:571-719-4181
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-01
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA10820000208000000X
NY309370208000000X
MDD0088144208000000X
VA0101276265208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics