Provider Demographics
NPI:1295792919
Name:GANDHI, DHIREN K (MD)
Entity type:Individual
Prefix:
First Name:DHIREN
Middle Name:K
Last Name:GANDHI
Suffix:
Gender:M
Credentials:MD
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:240 MATHISTOWN RD
Mailing Address - Street 2:SUITE 215
Mailing Address - City:LITTLE EGG HARBOR TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:08087-4061
Mailing Address - Country:US
Mailing Address - Phone:609-294-4232
Mailing Address - Fax:609-294-4235
Practice Address - Street 1:240 MATHISTOWN RD
Practice Address - Street 2:SUITE 215
Practice Address - City:LITTLE EGG HARBOR TWP
Practice Address - State:NJ
Practice Address - Zip Code:08087-4061
Practice Address - Country:US
Practice Address - Phone:609-294-4232
Practice Address - Fax:609-294-4235
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-27
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA07935900207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0117617Medicaid