Provider Demographics
NPI:1699410928
Name:GULATI, RISHI (DO)
Entity Type:Individual
Prefix:
First Name:RISHI
Middle Name:
Last Name:GULATI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 N 16TH ST APT 1112
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-1208
Mailing Address - Country:US
Mailing Address - Phone:703-350-5907
Mailing Address - Fax:
Practice Address - Street 1:4190 CITY AVE
Practice Address - Street 2:
Practice Address - City:19131
Practice Address - State:PA
Practice Address - Zip Code:19102
Practice Address - Country:US
Practice Address - Phone:703-581-4117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-02
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program