GRAND STREET MEDICAL PLLC NPI 1568485985

NPI Information

NPI: 1568485985
Provider Name: GRAND STREET MEDICAL PLLC

Doing Business As: JAYANT H. GANDHI,M.D.

Classification: General Practice - 208D00000X
Entity Type: Organization

CLIA Number: 33D2065725

Address:
666 GRAND ST
BROOKLYN, NY
ZIP 11211
Phone: (718) 963-0555
Get Directions

GRAND STREET MEDICAL PLLC is a general practice in Brooklyn, NY. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee GRAND STREET MEDICAL PLLC NPI is 1568485985. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Jayant H. Gandhi,m.d..

The provider's business location address is:

666 GRAND ST
BROOKLYN, NY
ZIP 11211-853
Phone: (718) 963-0555
Fax: (718) 963-4889

The provider's authorized official is Hema J Gandhi .
The authorized official title is Administration and has the following contact phone number (718) 782-4768.

The CLIA number assigned to this NPI record is 33D2065725 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/26/2006 and was last updated on 4/18/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine		111281	NEW YORK	No
2	207R00000X	Internal Medicine		111281	NEW YORK	No
3	207RG0300X	Internal Medicine	Geriatric Medicine	111281	NEW YORK	No
4	208100000X	Physical Medicine & Rehabilitation		111281	NEW YORK	No
5	208600000X	Surgery		111281	NEW YORK	No
6	207QA0401X	Family Medicine	Addiction Medicine			No
7	207QG0300X	Family Medicine	Geriatric Medicine			No
8	208D00000X	General Practice				No
9	207RX0202X	Internal Medicine	Medical Oncology			No
10	208D00000X	General Practice		111281	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	GJ617239	OTHER	NEW YORK	GHI
2	12295130	OTHER		CAQH
3	B78173	MEDICARE UPIN	NEW YORK
4	00199748	MEDICAID	NEW YORK
5	WPPD41	MEDICARE UPIN	NEW YORK
6	03196274	MEDICAID	NEW YORK
7	11128160NY	OTHER	NEW YORK	1199 NATIONAL BENEFIT
8	0192659	OTHER	NEW YORK	GRAND STREET MEDICAL PC
9	55247	OTHER	NEW YORK	HIP
10	WPPD41	MEDICAID	NEW YORK
11	582762	MEDICARE PIN	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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