Individual
PAUL GANDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
701 COTTAGE GROVE RD, SUITE E210, BLOOMFIELD, CT 06002-3080
(860) 243-9534
(860) 242-1464
Mailing address
701 COTTAGE GROVE RD, SUITE E210, BLOOMFIELD, CT 06002-3080
(860) 243-9534
(860) 242-1464
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
014875
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010014875CT01
ANTHEM BLUE SHIELD
CT
01
—
0V4118
HEALTHNET
—
Enumeration date
07/22/2006
Last updated
07/08/2007
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