Healthcare Provider Details

I. General information

NPI: 1104981976
Provider Name (Legal Business Name): TARAS TECHNIQUES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2006
Last Update Date: 07/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10432 BALLS FORD RD SUITE 300
MANASSAS VA
20109-2602
US

IV. Provider business mailing address

PO BOX 684
GAINESVILLE VA
20156-0684
US

V. Phone/Fax

Practice location:
  • Phone: 703-636-4123
  • Fax: 703-636-4123
Mailing address:
  • Phone: 703-636-4123
  • Fax: 703-636-4123

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State

VIII. Authorized Official

Name: TARAS NK RAGGIO
Title or Position: MANAGING PRINCIPAL DIRECTOR
Credential: HHP
Phone: 703-636-4123