Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QA0401X | Family Doctor - Addiction Medicine | 111281 | NY |
N | 207QA0505X | Family Doctor - Adult Medicine | 111281 | NY |
N | 207QG0300X | Family Doctor - Geriatric Medicine | 111281 | NY |
N | 208200000X | Surgeon | 111281 | NY |
N | 208600000X | Surgeon | 111281 | NY |
Y | 208D00000X | General Practice Physician | 111281 | NY |
N | 208D00000X | General Practice Physician | 111281-2 | NY |
NPI | 1235176355 |
---|---|
Provider Name | Dr. Jayant H Gandhi |
First Address | New York, NY 10028-8004 |
Second Address | New York, NY 10028-8004 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2006 |
Last Update Date | 23/04/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00199748 | (05) | NY |
1235176355 | NPI (01) | NY |
B78173 | (02) |