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Individual

IVAN RACADAG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
AGPCNP-BC

Contact information

Practice address
1604 SPRING HILL RD, SUITE 450, VIENNA, VA 22182-7510
(571) 599-5643
(703) 270-4350
Mailing address
2 UNIVERSITY PLZ STE 204, HACKENSACK, NJ 07601-6211
(551) 295-8223

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001230039
VA
363LA2200X
Adult Health Nurse Practitioner
Primary
0024173957
VA

Other

Enumeration date
05/26/2016
Last updated
09/11/2025
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