Healthcare Provider Details

I. General information

NPI: 1144282229
Provider Name (Legal Business Name): RHEA NISHITA MEHRA M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NISHITA KNECHTEL M.D

II. Dates (important events)

Enumeration Date: 04/04/2006
Last Update Date: 06/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

489 CARLISLE DR STE A
HERNDON VA
20170-4897
US

IV. Provider business mailing address

489 CARLISLE DR STE A
HERNDON VA
20170-4897
US

V. Phone/Fax

Practice location:
  • Phone: 703-774-3234
  • Fax: 703-880-8414
Mailing address:
  • Phone: 703-774-3234
  • Fax: 703-880-8414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number0101240596
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number0101240596
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: