Provider Demographics
NPI:1245562594
Name:SANYAL-DEY, PALLABI (MD)
Entity type:Individual
Prefix:
First Name:PALLABI
Middle Name:
Last Name:SANYAL-DEY
Suffix:
Gender:
Credentials:MD
Other - Prefix:DR
Other - First Name:PALLABI
Other - Middle Name:
Other - Last Name:SANYAL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:751 S BASCOM AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-2604
Mailing Address - Country:US
Mailing Address - Phone:510-350-2732
Mailing Address - Fax:510-879-9130
Practice Address - Street 1:1743 S SIDEWINDER DRIVE UNIT 114
Practice Address - Street 2:
Practice Address - City:PARK CITY
Practice Address - State:UT
Practice Address - Zip Code:84060
Practice Address - Country:US
Practice Address - Phone:307-840-9834
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-10
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0071496208M00000X
CAA110871207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist