Healthcare Provider Details

I. General information

NPI: 1003871484
Provider Name (Legal Business Name): ALPANA D. GANDHI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 CHANGEBRIDGE RD, B 6
MONTVILLE NJ
07045-9114
US

IV. Provider business mailing address

7 ASHLEY PL
TOWACO NJ
07082-1447
US

V. Phone/Fax

Practice location:
  • Phone: 973-882-4994
  • Fax:
Mailing address:
  • Phone: 973-334-4592
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMA4318600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: