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General NPI Number Information
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NPI Number | 1366538787
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Entity Type | Individual
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Provider Name | SANDEEP A GANDHI MD
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Gender | Male
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 06/18/2008
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Provider Practice Location Address
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Address Line | 1300 ROANOKE AVE
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City | RIVERHEAD
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State | NY
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Zip | 11901-2031
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Country | US
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Telephone | 888-695-0385
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Fax | 516-338-7984
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Provider Business Mailing Address
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Address Line | PO BOX 1362
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City | RONKONKOMA
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State | NY
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Zip | 11779-0829
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Country | US
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Telephone | 888-695-0385
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Fax | 516-338-7974
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 1914841
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License Number State | NY
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