OrganizationActive
Gateway Geriatric Services LLC
NPI 1114219417 · Geriatric Medicine (Internal Medicine) Physician · Saint Louis, MO
Provider details
- NPI number
- 1114219417
- Entity type
- Organization
- Primary specialty
- Geriatric Medicine (Internal Medicine) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Shailaja Pulisetty, Physician/President(314) 225-6015
- License
- 2005019644 (MO)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
12026 Conway Rd
Saint Louis, MO 63131-2417
Phone: (314) 225-6015
Approximate (ZIP-level) locationGet directions
Mailing address
12026 Conway Rd
Saint Louis, MO 63131-2417
Registry dates
- Enumerated
- 2011-05-05
- Last updated
- 2011-07-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.