Provider Demographics
NPI:1013154665
Name:DR RHEA N.MEHRA,M.D.INC
Entity Type:Organization
Organization Name:DR RHEA N.MEHRA,M.D.INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RHEA
Authorized Official - Middle Name:NISHITA
Authorized Official - Last Name:MEHRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-953-1557
Mailing Address - Street 1:489 CARLISLE DR STE A
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20170-4897
Mailing Address - Country:US
Mailing Address - Phone:703-953-1557
Mailing Address - Fax:703-880-8414
Practice Address - Street 1:2121 EISENHOWER AVE
Practice Address - Street 2:SUITE # 200 ( 2ND FLOOR )
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-4698
Practice Address - Country:US
Practice Address - Phone:703-953-1557
Practice Address - Fax:703-880-8414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-17
Last Update Date:2011-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2084P0800X
VA01012405962084P0805X, 261Q00000X, 261QM0850X, 261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric PsychiatryGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAH97603Medicare UPIN
VA020341P73Medicare PIN