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General NPI Number Information
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NPI Number | 1194298265
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Entity Type | Individual
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Provider Name | JAYRAJ B GANDHI
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Gender | Male
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Dates
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Enumeration Date | 01/10/2019
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Last Update Date | 01/10/2019
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Provider Practice Location Address
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Address Line | 23 ARN TER
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City | SECAUCUS
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State | NJ
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Zip | 07094-3837
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Country | US
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Telephone | 551-697-4740
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Fax |
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Provider Business Mailing Address
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Address Line | 3196 KENNEDY BLVD
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City | UNION CITY
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State | NJ
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Zip | 07087-2436
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Country | US
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Telephone | 551-697-4740
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 28RI03508800
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License Number State | NJ
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