Provider Demographics
NPI:1235141011
Name:GATTI, JASMINE
Entity Type:Individual
Prefix:DR
First Name:JASMINE
Middle Name:
Last Name:GATTI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7616 MASSENA RD.
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8218 WISCONSIN AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-3107
Practice Address - Country:US
Practice Address - Phone:301-656-5671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMD 00034726207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDD43778Medicare UPIN
MDG02008Medicare PIN