| Adult And Geriatric Psychiatry | |
|
19415 Deerfield Ave Ste 310 Lansdowne VA 20176-8452 | |
| (703) 858-0076 | |
| (703) 726-6394 |
| Full Name | Adult And Geriatric Psychiatry |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 19415 Deerfield Ave, Lansdowne, Virginia |
| Authorized Official Name and Position | Tara Mangat (PRESIDENT) |
| Authorized Official Contact | 7038580076 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Adult And Geriatric Psychiatry Po Box 825 Ashburn VA 20146-0825 Ph: (703) 858-0076 | Adult And Geriatric Psychiatry 19415 Deerfield Ave Ste 310 Lansdowne VA 20176-8452 Ph: (703) 858-0076 |
| NPI Number | 1386662971 |
|---|---|
| Provider Enumeration Date | 07/18/2006 |
| Last Update Date | 11/28/2007 |
| Medicare PECOS PAC ID | 9133108707 |
|---|---|
| Medicare Enrollment ID | O20040727001229 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386662971 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 0101232595 (Virginia) | Primary |
| Provider Name | Tara S Mangat |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649256603 PECOS PAC ID: 4486633054 Enrollment ID: I20040728000342 |
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