Individual
JOHN V GANDOLFO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
ONE ROOSEVELT AVENUE SUITE 204, PEABODY, MA 01960
(978) 536-7778
(978) 536-2998
Mailing address
ONE ROOSEVELT AVENUE SUITE 204, JOHN V GANDOLFO MD, PEABODY, MA 01960
(978) 536-7778
(978) 536-2998
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
48148
MA
207RG0100X
Gastroenterology Physician
48148
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
048148
TUFTS HEALTH PLANS
MA
05
—
6180884
—
MA
01
—
61925
HAVARD PILGRIM HEALTHCARE
MA
01
—
J02927
BLUE SHIELD OF MA
MA
Enumeration date
11/14/2006
Last updated
09/11/2025
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