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General NPI Number Information
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NPI Number | 1689782443
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Entity Type | Individual
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Provider Name | ANIL PRABHAKARAN PISHAROTY MD
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Gender | Male
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 07/03/2023
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Provider Practice Location Address
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Address Line | 92-29 QUEENS BLVD 1A
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City | REGO PARK
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State | NY
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Zip | 11374
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Country | US
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Telephone | 201-339-1700
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 79
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City | BAYONNE
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State | NJ
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Zip | 07002-0079
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Country | US
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Telephone | 201-339-1700
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Fax | 201-339-6972
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 204088
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 2040881
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License Number State | NY
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