Provider Demographics
NPI:1215166079
Name:GANDHI, URVI (MD)
Entity type:Individual
Prefix:DR
First Name:URVI
Middle Name:
Last Name:GANDHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-2917
Mailing Address - Country:US
Mailing Address - Phone:631-424-3787
Mailing Address - Fax:631-424-5868
Practice Address - Street 1:241 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-2917
Practice Address - Country:US
Practice Address - Phone:631-424-3787
Practice Address - Fax:631-424-5868
Is Sole Proprietor?:No
Enumeration Date:2009-07-14
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CT053847207R00000X
NY296125207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program