Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 0116035166 | VA |
NPI | 1003482183 |
---|---|
Provider Name | Sarah Marakos |
First Address | Falls Church, VA 22042-3307 |
Second Address | Falls Church, VA 22042-3307 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2021 |
Last Update Date | 31/05/2021 |