Healthcare Provider Details

I. General information

NPI: 1427186428
Provider Name (Legal Business Name): ASHISH GANDHI MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 09/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

451 ANDOVER ST STE G11
NORTH ANDOVER MA
01845
US

IV. Provider business mailing address

451 ANDOVER ST STE G11
NORTH ANDOVER MA
01845-5044
US

V. Phone/Fax

Practice location:
  • Phone: 978-208-0285
  • Fax: 978-655-7019
Mailing address:
  • Phone: 978-208-0285
  • Fax: 978-655-7019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RA0000X
TaxonomyAdolescent Medicine (Internal Medicine) Physician
License Number208345
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number208345
License Number StateMA

VIII. Authorized Official

Name: DR. ASHISH D GANDHI
Title or Position: PHYSICIAN
Credential: MD
Phone: 978-208-0285