Individual
DR. TATIANA GANDRABURA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
401 YOUNG AVE STE 245B, MOORESTOWN, NJ 08057-3132
(856) 727-0900
(856) 231-8428
Mailing address
1015 BRIGGS RD STE 200, MOUNT LAUREL, NJ 08054-4114
(856) 727-0900
(856) 231-8428
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
25MA09181800
NJ
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
25MA09181800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0346292
—
NJ
Enumeration date
05/22/2007
Last updated
02/19/2025
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