Provider Demographics
NPI:1033183868
Name:MEHNDIRATTA, YASH PAL (MD)
Entity Type:Individual
Prefix:DR
First Name:YASH
Middle Name:PAL
Last Name:MEHNDIRATTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10000 ABBEY DR
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-5430
Mailing Address - Country:US
Mailing Address - Phone:240-912-4683
Mailing Address - Fax:240-912-4695
Practice Address - Street 1:15200 SHADY GROVE RD
Practice Address - Street 2:SUITE 401
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3218
Practice Address - Country:US
Practice Address - Phone:240-912-4683
Practice Address - Fax:240-912-4695
Is Sole Proprietor?:No
Enumeration Date:2006-02-16
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD468102084N0400X
MDD00468102084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDG22958Medicare UPIN
MDG22958Medicare UPIN