Provider Demographics
NPI:1710302112
Name:RAVAL, VAIBHAVI (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:VAIBHAVI
Middle Name:
Last Name:RAVAL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2727 S GLEBE RD
Mailing Address - Street 2:APT # 301
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22206-2721
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2727 S GLEBE RD
Practice Address - Street 2:APT # 301
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22206-2721
Practice Address - Country:US
Practice Address - Phone:571-334-8517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-22
Last Update Date:2014-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202212709183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist