Healthcare Provider Details

I. General information

NPI: 1851825202
Provider Name (Legal Business Name): ORIT VARDI TRAGASH ND, LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2017
Last Update Date: 04/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

313 PRICE PL SUITE 113
MADISON WI
53705-3299
US

IV. Provider business mailing address

313 PRICE PL SUITE 113
MADISON WI
53705-3299
US

V. Phone/Fax

Practice location:
  • Phone: 608-335-9298
  • Fax:
Mailing address:
  • Phone: 608-335-9298
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number914-55
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number1076
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: