Provider Demographics
NPI:1568524577
Name:ARITA, ANTHONY A (PHD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:A
Last Name:ARITA
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1539 BRICE CIR
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:MD
Mailing Address - Zip Code:21037-4631
Mailing Address - Country:US
Mailing Address - Phone:410-798-4453
Mailing Address - Fax:
Practice Address - Street 1:624 WARRINGTON AVE SE
Practice Address - Street 2:BUILDING #183, WNY BRANCH NAVAL HEALTH CLINIC
Practice Address - City:WASHINGTON NAVY YARD
Practice Address - State:DC
Practice Address - Zip Code:20374-5022
Practice Address - Country:US
Practice Address - Phone:202-433-9204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0689103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical