Provider Demographics
NPI:1235427592
Name:REPAKA, NEEHARIKA (MD)
Entity Type:Individual
Prefix:
First Name:NEEHARIKA
Middle Name:
Last Name:REPAKA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1830 TOWN CENTER DR STE 306
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-3217
Mailing Address - Country:US
Mailing Address - Phone:571-450-8300
Mailing Address - Fax:
Practice Address - Street 1:1830 TOWN CENTER DR STE 306
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-3217
Practice Address - Country:US
Practice Address - Phone:571-450-8300
Practice Address - Fax:571-450-8301
Is Sole Proprietor?:No
Enumeration Date:2011-07-20
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD83298207RE0101X
VA0101269601207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism