Provider Demographics
NPI:1992974976
Name:CHATTERJEE, NEIL (MD)
Entity type:Individual
Prefix:
First Name:NEIL
Middle Name:
Last Name:CHATTERJEE
Suffix:
Gender:M
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:PO BOX 404783
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-0001
Mailing Address - Country:US
Mailing Address - Phone:703-709-1114
Mailing Address - Fax:
Practice Address - Street 1:1831 WIEHLE AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-5266
Practice Address - Country:US
Practice Address - Phone:703-709-1114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-25
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY60245963208100000X
VAVA0101248599208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation