Healthcare Provider Details

I. General information

NPI: 1538093588
Provider Name (Legal Business Name): TASNIM GHARIEB
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46697 PARAGON TER
STERLING VA
20164-6328
US

IV. Provider business mailing address

46697 PARAGON TER
STERLING VA
20164-6328
US

V. Phone/Fax

Practice location:
  • Phone: 973-934-1166
  • Fax:
Mailing address:
  • Phone: 973-934-1166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number0202223637
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: