Provider Demographics
NPI:1649243569
Name:GULATI, VIJAY K (MD)
Entity Type:Individual
Prefix:DR
First Name:VIJAY
Middle Name:K
Last Name:GULATI
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 1:200 LOTHROP STREET UPMC PHYSICIAN SERVICES
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213
Mailing Address - Country:US
Mailing Address - Phone:412-647-0148
Mailing Address - Fax:
Practice Address - Street 1:200 DELAFIELD ROAD
Practice Address - Street 2:SUITE 3010
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15215
Practice Address - Country:US
Practice Address - Phone:412-647-0148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2018-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD418482174400000X, 207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No174400000XOther Service ProvidersSpecialist
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001873462Medicaid
PA054195D9JMedicare ID - Type Unspecified