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General NPI Number Information
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NPI Number | 1962310599
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Entity Type | Organization
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Legal Business Name | EMERALD CITY MEDICAL PRACTICE PA
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Dates
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Enumeration Date | 09/01/2026
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Last Update Date | 09/01/2026
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Provider Practice Location Address
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Address Line | 1441 UTE BLVD STE 370
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City | PARK CITY
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State | UT
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Zip | 84098-7718
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Country | US
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Telephone | 307-840-9834
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Fax |
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Provider Business Mailing Address
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Address Line | 50 W BROADWAY STE 333
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City | SALT LAKE CITY
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State | UT
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Zip | 84101-2027
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SANYAL DAY PALLABI
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Credential |
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Telephone | 806-319-3154
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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