MEDICARE: DR. RAKESH GULATI MD

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	207RN0300X	Nephrology Physician	MD062663L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770571937
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAKESH GULATI MD

Provider Business Mailing Address
First Line	:	833 CHESTNUT ST
Second Line	:	SUITE 700
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-4414
Country	:	US
Telephone Number	:	215-503-3000
Fax Number	:	215-503-4099

Provider Business Practice Location Address
First Line	:	833 CHESTNUT ST
Second Line	:	SUITE 700
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-4414
Country	:	US
Telephone Number	:	215-503-3000
Fax Number	:	215-503-4099

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

Provider Enumeration Date	:	10/12/2005
Last Update Date	:	06/22/2019

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