Provider Demographics
NPI:1023305281
Name:GANDHI, SOREN (MD)
Entity type:Individual
Prefix:DR
First Name:SOREN
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 1:575 UNDERHILL BLVD STE 200&210
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-3426
Mailing Address - Country:US
Mailing Address - Phone:168-224-4404
Mailing Address - Fax:
Practice Address - Street 1:575 UNDERHILL BLVD STE 200&210
Practice Address - Street 2:
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-3426
Practice Address - Country:US
Practice Address - Phone:168-224-4404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-07
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR8897207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology