Provider Demographics
NPI:1255731253
Name:JOSHI, MRINAL (MD)
Entity type:Individual
Prefix:
First Name:MRINAL
Middle Name:
Last Name:JOSHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1497 CARROLL ST APT 67
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11213-4581
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:515 FAIRMOUNT AVE STE 340
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21286-8522
Practice Address - Country:US
Practice Address - Phone:410-769-6269
Practice Address - Fax:410-584-2252
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-26
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0089509207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine