Healthcare Provider Details

I. General information

NPI: 1457486284
Provider Name (Legal Business Name): BINALI MEHTA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 02/12/2020
Certification Date: 02/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5225 WISCONSIN AVE NW STE 400
WASHINGTON DC
20015-2055
US

IV. Provider business mailing address

6225 WESTERN AVE NW
WASHINGTON DC
20015-2465
US

V. Phone/Fax

Practice location:
  • Phone: 202-363-1010
  • Fax: 202-363-2383
Mailing address:
  • Phone: 202-363-1010
  • Fax: 202-363-2383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberD0062911
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: