Provider Demographics
NPI:1639342439
Name:MANGALMURTI, NILAM SURYAKANT (MD)
Entity Type:Individual
Prefix:DR
First Name:NILAM
Middle Name:SURYAKANT
Last Name:MANGALMURTI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:NILAM
Other - Middle Name:SURYAKANT
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3615 CIVIC CENTER BOULEVARD,
Mailing Address - Street 2:SUITE 1015F ABRAMSON RESEARCH BUILDING
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104
Mailing Address - Country:US
Mailing Address - Phone:215-573-9918
Mailing Address - Fax:215-573-4469
Practice Address - Street 1:3615 CIVIC CENTER BLVD STE 1015F
Practice Address - Street 2:ABRAMSON RESEARCH BUILDING
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4318
Practice Address - Country:US
Practice Address - Phone:215-573-9918
Practice Address - Fax:215-573-4469
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-12
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD432632207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease