Provider Demographics
NPI: | 1063881704 |
---|---|
Name: | NABI SANTE INC |
Entity type: | Organization |
Organization Name: | NABI SANTE INC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | ANISSA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | NABI |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 202-368-4903 |
Mailing Address - Street 1: | 430 M ST SW |
Mailing Address - Street 2: | APT NO 105 |
Mailing Address - City: | WASHINGTON |
Mailing Address - State: | DC |
Mailing Address - Zip Code: | 20024-2602 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 202-368-4903 |
Mailing Address - Fax: | 202-863-1320 |
Practice Address - Street 1: | 1276 N WAYNE ST |
Practice Address - Street 2: | SUITE #506 |
Practice Address - City: | ARLINGTON |
Practice Address - State: | VA |
Practice Address - Zip Code: | 22201-5848 |
Practice Address - Country: | US |
Practice Address - Phone: | 202-368-4903 |
Practice Address - Fax: | 202-863-1320 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2015-09-23 |
Last Update Date: | 2015-09-23 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
MD | D0062289 | 207R00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Single Specialty |