Organization
GANDAPARSIN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MITESWAR PUREWAL MD (PARTNER)
(888) 990-2653
Entity
Organization
Contact information
Practice address
1519 WALLACE ST, PHILADELPHIA, PA 19130-3446
(888) 990-2653
Mailing address
1519 WALLACE ST, PHILADELPHIA, PA 19130-3446
(888) 990-2653
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
11/29/2018
Last updated
05/23/2019
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