Healthcare Provider Details

I. General information

NPI: 1477734986
Provider Name (Legal Business Name): NISHANT ASHOK GANDHI DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2007
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9000 BROOKTREE RD STE 110
WEXFORD PA
15090-9288
US

IV. Provider business mailing address

9000 BROOKTREE RD STE 110
WEXFORD PA
15090-9288
US

V. Phone/Fax

Practice location:
  • Phone: 412-203-8779
  • Fax: 412-871-0279
Mailing address:
  • Phone: 412-203-8779
  • Fax: 412-871-0279

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number263559
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberOS019510
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberOS019510
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number263559
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: