Provider Demographics
NPI:1821824129
Name:AL SAIDI, TAIBA
Entity type:Individual
Prefix:
First Name:TAIBA
Middle Name:
Last Name:AL SAIDI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2551 JOHN MILTON DR
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20171-2527
Mailing Address - Country:US
Mailing Address - Phone:703-620-9664
Mailing Address - Fax:
Practice Address - Street 1:2551 JOHN MILTON DR
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20171-2527
Practice Address - Country:US
Practice Address - Phone:703-620-9664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-12
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202222319183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist