Healthcare Provider Details

I. General information

NPI: 1134506520
Provider Name (Legal Business Name): NETA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2015
Last Update Date: 10/29/2020
Certification Date: 10/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 N QUINCY ST STE 601
ARLINGTON VA
22203-1729
US

IV. Provider business mailing address

801 N QUINCY ST STE 601
ARLINGTON VA
22203-1729
US

V. Phone/Fax

Practice location:
  • Phone: 703-812-4642
  • Fax: 703-812-7926
Mailing address:
  • Phone: 703-812-4642
  • Fax: 703-812-7926

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: NEEL VILAS NENE
Title or Position: PRESIDENT
Credential: MD
Phone: 703-244-6215