Provider Demographics
NPI:1174823397
Name:GANDHI, PURVI AMIT (MACCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:PURVI
Middle Name:AMIT
Last Name:GANDHI
Suffix:
Gender:F
Credentials:MACCC-SLP
Other - Prefix:MISS
Other - First Name:PURVI
Other - Middle Name:HARENDRA
Other - Last Name:MODY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15920 81ST ST
Mailing Address - Street 2:
Mailing Address - City:HOWARD BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11414-2921
Mailing Address - Country:US
Mailing Address - Phone:917-860-3373
Mailing Address - Fax:
Practice Address - Street 1:8212 151ST AVE
Practice Address - Street 2:
Practice Address - City:HOWARD BEACH
Practice Address - State:NY
Practice Address - Zip Code:11414-1761
Practice Address - Country:US
Practice Address - Phone:718-848-0300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-22
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016449-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist