Provider Demographics
NPI:1013012772
Name:GINDI, EDWARD J (MD)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:J
Last Name:GINDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:1636 E 14TH ST STE 108
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-1100
Mailing Address - Country:US
Mailing Address - Phone:718-376-6425
Mailing Address - Fax:718-376-6427
Practice Address - Street 1:1636 E 14TH ST STE 108
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1100
Practice Address - Country:US
Practice Address - Phone:718-376-6425
Practice Address - Fax:718-376-6427
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY149046207KA0200X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
B15323Medicare UPIN