Individual
DR. RACHELLE GRACE GANDICA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1150 SAINT NICHOLAS AVE, 2ND FLOOR, NEW YORK, NY 10032
(212) 851-5494
(212) 851-5493
Mailing address
1150 ST. NICHOLAS AVE. 2ND FLOOR, NAOMI BERRIE DIABETES CENTER, NEW YORK, NY 10032
(212) 851-5494
(212) 851-5493
Taxonomy
Speciality
Code
Description
License number
State
2080P0205X
Pediatric Endocrinology Physician
Primary
241275-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03395113
—
NY
01
—
A400045971
MEDICARE ID
NY
Enumeration date
06/01/2007
Last updated
08/23/2018
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