Provider Demographics
NPI:1912081514
Name:AYALEW, SABA E (OD)
Entity Type:Individual
Prefix:DR
First Name:SABA
Middle Name:E
Last Name:AYALEW
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 PENN AVE NW
Mailing Address - Street 2:METROPOLITAN OPTICAL
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20006
Mailing Address - Country:US
Mailing Address - Phone:202-659-6555
Mailing Address - Fax:202-659-2134
Practice Address - Street 1:2000 PENN AVE NW
Practice Address - Street 2:METROPOLITAN OPTICAL
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006
Practice Address - Country:US
Practice Address - Phone:202-659-6555
Practice Address - Fax:202-659-2134
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCOP562152W00000X
VAOP562152W00000X
MDOP562152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCG01677M01Medicare ID - Type Unspecified
V01806Medicare UPIN