| Doctor Name: | DR. NEERAJ GANDOTRA |
| NPI Number: | 1184801813 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | D0067343 |
| Business Practice Address: | 4940 Eastern Ave Jhbmc Baltimore, MD - 212242735 |
| Business Phone Number: | 4105500100 |
| Business Fax Number: | |
| Mailing Address: | 1253 4th St Sw, WASHINGTON |
| State: | DC |
| Postal Code: | 200242307 |
| Phone Number: | 4438389722 |
| Fax Number: | |
| NPI Enumeration Date: | 01/24/2008 |
| NPI Last Update Date: | 07/21/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2084A0401X |
| License Number: | D0067343 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Psychiatry & Neurology |
| Taxonomy Specialization: | Addiction Medicine |
| Taxonomy Definition: | A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |