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Individual

JASON GANDELMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
177 FORT WASHINGTON AVE, NEW YORK, NY 10032-3733
(212) 305-3090
Mailing address
1051 RIVERSIDE DR UNIT 103, NEW YORK, NY 10032-1007

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
1455
CA
2084P0800X
Psychiatry Physician
Primary
321486
NY
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
03/19/2019
Last updated
05/11/2024
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