Provider Demographics
NPI:1205332525
Name:PILLARISETTY, SAI SHALINI (MD)
Entity type:Individual
Prefix:
First Name:SAI SHALINI
Middle Name:
Last Name:PILLARISETTY
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 OCEAN PARKWAY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235
Mailing Address - Country:US
Mailing Address - Phone:718-616-3000
Mailing Address - Fax:
Practice Address - Street 1:505 NE 87TH AVE STE 350
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98664-1965
Practice Address - Country:US
Practice Address - Phone:360-514-2550
Practice Address - Fax:360-514-1927
Is Sole Proprietor?:No
Enumeration Date:2018-04-04
Last Update Date:2025-04-24
Deactivation Date:2018-11-16
Deactivation Code:
Reactivation Date:2018-12-07
Provider Licenses
StateLicense IDTaxonomies
390200000X
WAMD61608192207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program