Healthcare Provider Details

I. General information

NPI: 1013154665
Provider Name (Legal Business Name): DR RHEA N.MEHRA,M.D.INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2009
Last Update Date: 06/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 EISENHOWER AVE SUITE # 200 ( 2ND FLOOR )
ALEXANDRIA VA
22314-4698
US

IV. Provider business mailing address

489 CARLISLE DR STE A
HERNDON VA
20170-4897
US

V. Phone/Fax

Practice location:
  • Phone: 703-953-1557
  • Fax: 703-880-8414
Mailing address:
  • Phone: 703-953-1557
  • Fax: 703-880-8414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number0101240596
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number0101240596
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number0101240596
License Number StateVA
# 5
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number0101240596
License Number StateVA

VIII. Authorized Official

Name: DR. RHEA NISHITA MEHRA
Title or Position: OWNER
Credential: M.D
Phone: 703-953-1557