Provider Demographics
NPI:1245285659
Name:ABO-LUBITZ, ALYSSA M (MD)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:M
Last Name:ABO-LUBITZ
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6683 MCLEAN DR
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-4002
Mailing Address - Country:US
Mailing Address - Phone:610-393-1348
Mailing Address - Fax:
Practice Address - Street 1:PM PEDIATRICS
Practice Address - Street 2:11056 ROUTE 29
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030
Practice Address - Country:US
Practice Address - Phone:703-552-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD0412852080P0204X
MA227865208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics