Organization
DIVINE VAGINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARIA TAVANA DPT (OWNER/PHYSICAL THERAPIST)
(973) 876-2509
Entity
Organization
Contact information
Practice address
20 CLOVER LN, RANDOLPH, NJ 07869-4529
(973) 876-2509
(973) 876-2509
Mailing address
20 CLOVER LN, RANDOLPH, NJ 07869-4529
(973) 876-2509
(973) 876-2509
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
05/15/2026
Last updated
05/15/2026
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