Provider Demographics
NPI:1962389338
Name:SARDAB, TARIG A (RPH)
Entity type:Individual
Prefix:
First Name:TARIG
Middle Name:A
Last Name:SARDAB
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14421 MANASSAS GAP CT
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20120-2863
Mailing Address - Country:US
Mailing Address - Phone:571-337-1340
Mailing Address - Fax:
Practice Address - Street 1:10301 NEW GUINEA RD
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22032-3268
Practice Address - Country:US
Practice Address - Phone:703-764-5112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202223060183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist