Provider Demographics
NPI:1396552923
Name:MISHRA, ARUN P
Entity type:Individual
Prefix:
First Name:ARUN
Middle Name:P
Last Name:MISHRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12811 MELVILLE LN
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22033-3635
Mailing Address - Country:US
Mailing Address - Phone:703-342-6150
Mailing Address - Fax:
Practice Address - Street 1:12811 MELVILLE LN
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22033-3635
Practice Address - Country:US
Practice Address - Phone:703-342-6150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-17
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator