Provider Demographics
NPI:1568432987
Name:YASIN, SABHA (MD)
Entity Type:Individual
Prefix:
First Name:SABHA
Middle Name:
Last Name:YASIN
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 1:2122 MCCONVEY PL
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22043-3068
Mailing Address - Country:US
Mailing Address - Phone:703-370-6386
Mailing Address - Fax:703-370-1699
Practice Address - Street 1:4660 KENMORE AVE
Practice Address - Street 2:SUITE 600
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-1313
Practice Address - Country:US
Practice Address - Phone:703-370-6386
Practice Address - Fax:703-370-1699
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101245174207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC182195YA24OtherMEDICARE DC
DC182195YA24OtherMEDICARE DC