| Doctor Name: | JESSICA GANDHI |
| NPI Number: | 1003226036 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | 0110-004568 |
| Business Practice Address: | 19455 Deerfield Ave Suite #201 Lansdowne, VA - 201768100 |
| Business Phone Number: | 7037236322 |
| Business Fax Number: | |
| Mailing Address: | 19455 Deerfield Ave, Ste 201 LANSDOWNE |
| State: | VA |
| Postal Code: | 201768102 |
| Phone Number: | 7037236322 |
| Fax Number: | |
| NPI Enumeration Date: | 04/29/2014 |
| NPI Last Update Date: | 03/29/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 0110-004568 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |