Provider Demographics
NPI:1235380767
Name:PATIL, VRISHALI SWANAND (MD)
Entity Type:Individual
Prefix:
First Name:VRISHALI
Middle Name:SWANAND
Last Name:PATIL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:VRISHALI
Other - Middle Name:HARISHCHANDRA
Other - Last Name:PIMPARE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:55 MADISON AVENUE
Mailing Address - Street 2:SUITE 310
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960
Mailing Address - Country:US
Mailing Address - Phone:973-993-9536
Mailing Address - Fax:973-998-4237
Practice Address - Street 1:55 MADISON AVENUE
Practice Address - Street 2:SUITE 310
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960
Practice Address - Country:US
Practice Address - Phone:973-993-9536
Practice Address - Fax:973-998-4237
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-02
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08631700207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine