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General NPI Number Information
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NPI Number | 1811951635
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Entity Type | Individual
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Provider Name | JATIN D GANDHI MD
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Gender | Male
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Dates
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Enumeration Date | 04/17/2006
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Last Update Date | 04/23/2010
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Provider Practice Location Address
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Address Line | 390 N BROADWAY SUITE 500
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City | PENNSVILLE
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State | NJ
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Zip | 08070-1253
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Country | US
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Telephone | 856-678-7474
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Fax | 856-678-3018
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Provider Business Mailing Address
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Address Line | PO BOX 109
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City | SHILOH
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State | NJ
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Zip | 08353-0109
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Country | US
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Telephone | 856-451-9395
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Fax | 856-451-8615
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 25MA03647300
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License Number State | NJ
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