Provider Demographics
NPI:1104863463
Name:MEHNDIRATTA, PA
Entity Type:Organization
Organization Name:MEHNDIRATTA, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:YASH
Authorized Official - Middle Name:
Authorized Official - Last Name:MEHNDIRATTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-466-7485
Mailing Address - Street 1:PO BOX 6330
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20015-0330
Mailing Address - Country:US
Mailing Address - Phone:301-498-2922
Mailing Address - Fax:301-498-3074
Practice Address - Street 1:3411 OLANDWOOD CT
Practice Address - Street 2:SUITE 105
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-1488
Practice Address - Country:US
Practice Address - Phone:301-924-0452
Practice Address - Fax:301-498-3074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDKFT2MEOtherGROUP PROVIDER# CAREFIRST
DCJ082OtherGROUP PROVIDER# CAREFIRST
MDKFT2MEOtherGROUP PROVIDER# CAREFIRST