Provider Demographics
NPI:1326365867
Name:JATIN D GANDHI MD PA
Entity Type:Organization
Organization Name:JATIN D GANDHI MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JATIN
Authorized Official - Middle Name:D
Authorized Official - Last Name:GANDHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-678-7474
Mailing Address - Street 1:PO BOX 109
Mailing Address - Street 2:
Mailing Address - City:SHILOH
Mailing Address - State:NJ
Mailing Address - Zip Code:08353-0109
Mailing Address - Country:US
Mailing Address - Phone:856-678-7474
Mailing Address - Fax:856-678-3018
Practice Address - Street 1:390 N BROADWAY
Practice Address - Street 2:500
Practice Address - City:PENNSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08070-1253
Practice Address - Country:US
Practice Address - Phone:856-678-7474
Practice Address - Fax:856-678-3018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-23
Last Update Date:2010-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty