Provider Demographics
NPI:1346347911
Name:ELITE OB/GYN
Entity Type:Organization
Organization Name:ELITE OB/GYN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:DIPAOLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-351-9700
Mailing Address - Street 1:3801 FAIRFAX DR
Mailing Address - Street 2:SUITE 31
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22203-1762
Mailing Address - Country:US
Mailing Address - Phone:703-351-9700
Mailing Address - Fax:703-351-5350
Practice Address - Street 1:3801 FAIRFAX DR
Practice Address - Street 2:SUITE 31
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22203-1762
Practice Address - Country:US
Practice Address - Phone:703-351-9700
Practice Address - Fax:703-351-5350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
130525Medicare ID - Type Unspecified