Provider Demographics
NPI:1508953027
Name:GANDHI, GOVINDAN (MD)
Entity Type:Individual
Prefix:DR
First Name:GOVINDAN
Middle Name:
Last Name:GANDHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:970 N BROADWAY
Mailing Address - Street 2:SUITE 309
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-1309
Mailing Address - Country:US
Mailing Address - Phone:914-965-0625
Mailing Address - Fax:914-965-0107
Practice Address - Street 1:970 N BROADWAY
Practice Address - Street 2:SUITE 309
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-1309
Practice Address - Country:US
Practice Address - Phone:914-965-0625
Practice Address - Fax:914-965-0107
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2024-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY135684208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWS951OtherOXFORD
NY2831958OtherAETNA
NY26478POtherHEALTH INSURANCE PLAN
NY6957OtherAFFINITY
NY22A92OtherBLUE CROSS BLUE SHIELD
NY40426012313OtherFIDELIS CARE OF NY
NY00437756Medicaid
NY0D3817OtherHEALTHNET
NY22A92OtherBLUE CROSS BLUE SHIELD
NY40426012313OtherFIDELIS CARE OF NY