Provider Demographics
NPI:1144282229
Name:MEHRA, RHEA NISHITA (MD)
Entity type:Individual
Prefix:DR
First Name:RHEA
Middle Name:NISHITA
Last Name:MEHRA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:NISHITA
Other - Middle Name:
Other - Last Name:KNECHTEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
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:703-774-3234
Mailing Address - Fax:703-880-8414
Practice Address - Street 1:489 CARLISLE DR STE A
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-4897
Practice Address - Country:US
Practice Address - Phone:703-774-3234
Practice Address - Fax:703-880-8414
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2011-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012405962084P0800X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1008490260001Medicaid
PA075080Medicare ID - Type Unspecified
VA020341P73Medicare PIN
PA1008490260001Medicaid