Provider Demographics
NPI:1003871484
Name:GANDHI, ALPANA D (MD)
Entity Type:Individual
Prefix:DR
First Name:ALPANA
Middle Name:D
Last Name:GANDHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 ASHLEY PL
Mailing Address - Street 2:
Mailing Address - City:TOWACO
Mailing Address - State:NJ
Mailing Address - Zip Code:07082-1447
Mailing Address - Country:US
Mailing Address - Phone:973-334-4592
Mailing Address - Fax:
Practice Address - Street 1:170 CHANGEBRIDGE RD,
Practice Address - Street 2:B 6
Practice Address - City:MONTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07045-9114
Practice Address - Country:US
Practice Address - Phone:973-882-4994
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA4318600208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1758101Medicaid
NJ454169Medicare ID - Type Unspecified
NJ1758101Medicaid