Provider Demographics
NPI:1891391082
Name:GANDHI, NISHITH VADILAL (PHARMACIST)
Entity type:Individual
Prefix:
First Name:NISHITH
Middle Name:VADILAL
Last Name:GANDHI
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:NISHITH
Other - Middle Name:VADILAL
Other - Last Name:GANDHI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:9120 SYBERT DR
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-6434
Mailing Address - Country:US
Mailing Address - Phone:443-750-5975
Mailing Address - Fax:
Practice Address - Street 1:8730 LIBERTY RD
Practice Address - Street 2:
Practice Address - City:RANDALLSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21133-4710
Practice Address - Country:US
Practice Address - Phone:443-576-3155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-11
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD13131183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist