Basic Information
| Provider Information | |||||||||
| NPI: | 1326365867 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JATIN D GANDHI MD PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 109 | ||||||||
| Address2: | |||||||||
| City: | SHILOH | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 083530109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8566787474 | ||||||||
| FaxNumber: | 8566783018 | ||||||||
| Practice Location | |||||||||
| Address1: | 390 N BROADWAY | ||||||||
| Address2: | 500 | ||||||||
| City: | PENNSVILLE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080701253 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8566787474 | ||||||||
| FaxNumber: | 8566783018 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/23/2010 | ||||||||
| LastUpdateDate: | 04/26/2010 | ||||||||
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| AuthorizedOfficialLastName: | GANDHI | ||||||||
| AuthorizedOfficialFirstName: | JATIN | ||||||||
| AuthorizedOfficialMiddleName: | D | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8566787474 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.