MEDICARE: RISHI GULATI DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	OS023747	PA
2	390200000X	Student in an Organized Health Care Education/Training Program
3	390200000X	Student in an Organized Health Care Education/Training Program	OS023747	PA

General Provider Information

NPI Number	:	1699410928
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RISHI GULATI DO

Provider Business Mailing Address
First Line	:	3000 S NORTHBANK PL
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19125-4517
Country	:	US
Telephone Number	:	703-581-4117
Fax Number	:

Provider Business Practice Location Address
First Line	:	3000 S NORTHBANK PL
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19125-4517
Country	:	US
Telephone Number	:	703-581-4117
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/02/2022
Last Update Date	:	06/07/2026

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Directions to “ RISHI GULATI DO” Practice Location

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