Provider Demographics
NPI:1992056139
Name:SARSAH, JOEL (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:
Last Name:SARSAH
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1690 OLD BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-8006
Mailing Address - Country:US
Mailing Address - Phone:703-494-8000
Mailing Address - Fax:571-572-3647
Practice Address - Street 1:1690 OLD BRIDGE RD
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-8006
Practice Address - Country:US
Practice Address - Phone:703-494-8000
Practice Address - Fax:571-572-3647
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-27
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202207491183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6717980001Medicare NSC