Provider Demographics
NPI:1063528040
Name:ARBABI, NILOOFAR (MD)
Entity type:Individual
Prefix:
First Name:NILOOFAR
Middle Name:
Last Name:ARBABI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7412 GEORGETOWN CT
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22102-2123
Mailing Address - Country:US
Mailing Address - Phone:703-346-1510
Mailing Address - Fax:703-848-4652
Practice Address - Street 1:1760 RESTON PKWY
Practice Address - Street 2:SUITE 400
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-3388
Practice Address - Country:US
Practice Address - Phone:703-467-9444
Practice Address - Fax:703-467-8484
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2009-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101235758208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA011723C77Medicare PIN