Healthcare Provider Details

I. General information

NPI: 1811902240
Provider Name (Legal Business Name): DHIREN GANDHI MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 06/09/2023
Certification Date: 06/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 MATHISTOWN RD SUITE 215
LITTLE EGG HARBOR NJ
08087-4061
US

IV. Provider business mailing address

240 MATHISTOWN RD
LITTLE EGG HARBOR TWP NJ
08087-4061
US

V. Phone/Fax

Practice location:
  • Phone: 609-294-4232
  • Fax: 609-294-4235
Mailing address:
  • Phone: 609-294-4232
  • Fax: 609-294-4235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMA07935900
License Number StateNJ

VIII. Authorized Official

Name: DHIREN K GANDHI
Title or Position: PRINCIPAL MEMBER
Credential: MD
Phone: 609-294-4232