Provider Demographics
NPI:1437378148
Name:SAFA, SARAH (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:
Last Name:SAFA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19450 DEERFIELD AVE
Mailing Address - Street 2:SUITE 275
Mailing Address - City:LANSDOWNE
Mailing Address - State:VA
Mailing Address - Zip Code:20176-6820
Mailing Address - Country:US
Mailing Address - Phone:703-729-5553
Mailing Address - Fax:703-729-1694
Practice Address - Street 1:19450 DEERFIELD AVE
Practice Address - Street 2:SUITE 275
Practice Address - City:LANSDOWNE
Practice Address - State:VA
Practice Address - Zip Code:20176-6820
Practice Address - Country:US
Practice Address - Phone:703-729-5553
Practice Address - Fax:703-729-1694
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110002242363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical