Healthcare Provider Details

I. General information

NPI: 1205069085
Provider Name (Legal Business Name): GAYATRIBEN GADANI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2009
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25101 CHAGRIN BLVD STE 100
BEACHWOOD OH
44122-5694
US

IV. Provider business mailing address

832 HEATHERHAVEN DRIVE
BALLWIN MO
63011
US

V. Phone/Fax

Practice location:
  • Phone: 216-468-5000
  • Fax:
Mailing address:
  • Phone: 952-687-1604
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number35.137188
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: