Provider Demographics
NPI:1922103894
Name:GANDHI, OM P (MD)
Entity Type:Individual
Prefix:DR
First Name:OM
Middle Name:P
Last Name:GANDHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:975 CLIFTON AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-2722
Mailing Address - Country:US
Mailing Address - Phone:973-471-9116
Mailing Address - Fax:973-471-0486
Practice Address - Street 1:975 CLIFTON AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-2722
Practice Address - Country:US
Practice Address - Phone:973-471-9116
Practice Address - Fax:973-471-0486
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA02719800207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery