Organization
ADULT AND GERIATRIC PSYCHIATRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARA MANGAT MD (PRESIDENT)
(703) 858-0076
Entity
Organization
Contact information
Practice address
19415 DEERFIELD AVE, STE 310, LANSDOWNE, VA 20176-8452
(703) 858-0076
(703) 726-6394
Mailing address
PO BOX 825, ASHBURN, VA 20146-0825
(703) 858-0076
(703) 726-6394
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
0101232595
VA
Other
Enumeration date
07/18/2006
Last updated
11/28/2007
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