Provider Demographics
NPI:1689889693
Name:GANDHI, KSHANILA (PT)
Entity Type:Individual
Prefix:MS
First Name:KSHANILA
Middle Name:
Last Name:GANDHI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3510 RAYMOOR RD
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-3126
Mailing Address - Country:US
Mailing Address - Phone:301-685-3557
Mailing Address - Fax:
Practice Address - Street 1:9020 OLD GEORGETOWN RD
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-1514
Practice Address - Country:US
Practice Address - Phone:301-660-3209
Practice Address - Fax:646-219-2840
Is Sole Proprietor?:No
Enumeration Date:2007-05-12
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD21633225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD285026YNKTMedicare PIN