1205332525 NPI number — SAI SHALINI PILLARISETTY M.D

Table of content: RODRENE DURANT (NPI 1376263384)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205332525 NPI number — SAI SHALINI PILLARISETTY M.D

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PILLARISETTY
Provider First Name:
SAI SHALINI
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1205332525
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/24/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
11/16/2018
NPI Reactivation Date:
12/07/2018

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2601 OCEAN PARKWAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BROOKLYN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11235
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-616-3000
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
505 NE 87TH AVE STE 350
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VANCOUVER
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98664-1965
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-514-2550
Provider Business Practice Location Address Fax Number:
360-514-1927
Provider Enumeration Date:
04/04/2018

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RH0003X , with the licence number: MD61608192 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)