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General NPI Number Information
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NPI Number | 1578191060
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Entity Type | Individual
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Provider Name | NEIL KIRAN RUSTGI
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Gender | Male
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Dates
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Enumeration Date | 03/30/2020
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Last Update Date | 09/30/2024
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Provider Practice Location Address
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Address Line | 5454 WISCONSIN AVE STE 1275
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City | CHEVY CHASE
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State | MD
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Zip | 20815-6933
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Country | US
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Telephone | 240-743-4535
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Fax |
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Provider Business Mailing Address
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Address Line | 5454 WISCONSIN AVE STE 1275
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City | CHEVY CHASE
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State | MD
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Zip | 20815-6933
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | D0100701
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License Number State | MD
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