Provider Demographics
NPI:1053354399
Name:AGGARWAL, SARA LEE (OD)
Entity type:Individual
Prefix:DR
First Name:SARA
Middle Name:LEE
Last Name:AGGARWAL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 E JEFFERSON ST
Mailing Address - Street 2:STE 6 W - PPQA KAISER PERM
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4908
Mailing Address - Country:US
Mailing Address - Phone:301-816-5853
Mailing Address - Fax:301-816-7133
Practice Address - Street 1:800 K ST NW
Practice Address - Street 2:64
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-8000
Practice Address - Country:US
Practice Address - Phone:202-898-1060
Practice Address - Fax:202-898-0472
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618002022152W00000X
DCOP1000225152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC273055YJM5Medicare PIN