Provider Demographics
NPI:1366177081
Name:SADR, TARA LEIGH (PA-C)
Entity type:Individual
Prefix:
First Name:TARA
Middle Name:LEIGH
Last Name:SADR
Suffix:
Gender:F
Credentials:PA-C
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Other - Credentials:
Mailing Address - Street 1:405 SUMMER GARDEN WAY
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-2888
Mailing Address - Country:US
Mailing Address - Phone:240-426-5625
Mailing Address - Fax:
Practice Address - Street 1:1920 L ST NW STE 350
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-5072
Practice Address - Country:US
Practice Address - Phone:301-869-9776
Practice Address - Fax:301-762-3721
Is Sole Proprietor?:No
Enumeration Date:2022-07-18
Last Update Date:2024-05-02
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant