Provider Demographics
NPI:1386012284
Name:RABY, LATOYA (PA)
Entity Type:Individual
Prefix:
First Name:LATOYA
Middle Name:
Last Name:RABY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8116 ARLINGTON BLVD
Mailing Address - Street 2:SUITE 183
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-1002
Mailing Address - Country:US
Mailing Address - Phone:703-659-4557
Mailing Address - Fax:703-205-9010
Practice Address - Street 1:8116 ARLINGTON BLVD
Practice Address - Street 2:SUITE 183
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-1002
Practice Address - Country:US
Practice Address - Phone:703-659-4557
Practice Address - Fax:703-205-9010
Is Sole Proprietor?:No
Enumeration Date:2015-09-09
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
246ZC0007X
VA0110006815363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
0012OtherNCCSA
VA4490OtherNSAA