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General NPI Number Information
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NPI Number | 1902111842
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Entity Type | Individual
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Provider Name | KINNARI C GANDHI
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Gender | Female
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Dates
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Enumeration Date | 08/16/2010
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Last Update Date | 08/16/2010
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Provider Practice Location Address
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Address Line | 139 S ORANGE AVE
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City | SOUTH ORANGE
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State | NJ
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Zip | 07079-1901
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Country | US
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Telephone | 973-275-3845
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Fax |
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Provider Business Mailing Address
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Address Line | 20 N EVERGREEN RD # 293 S
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City | EDISON
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State | NJ
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Zip | 08837-2218
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Country | US
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Telephone | 201-962-6501
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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 | 28RI03348900
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License Number State | NJ
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