DR. NEERAJ GANDOTRA (NPI# 1184801813) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184801813 |
| Entity Type | Individual |
| Full Name | DR. NEERAJ GANDOTRA |
| Credential | M.D. |
| Practice Address |
4940 Eastern Ave Jhbmc Baltimore MD 21224-2735 |
| Mailing Address |
1253 4th St Sw Washington DC 20024-2307 |
| Practice Telephone | 4105500100 |
| Mailing Telephone | 4438389722 |
| Enumeration Date | 2008-01-24 |
| Last Update Date | 2008-07-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084A0401X |
Psychiatry & Neurology Specialization: Addiction Medicine |
D0067343 | MD | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 018329600 | 05 |
| Street Address |
4940 EASTERN AVE JHBMC |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21224-2735 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841295714 | Jerome M Shier | Allergy & Immunology | 4940 Eastern Ave, Baltimore, MD 21224-2735 | 2005-06-16 |
| 1740889609 | Haimanot Mulat | Nurse Practitioner | 4940 Eastern Ave, Baltimore, MD 21224-2735 | 2020-10-21 |
| 1457958704 | Ashley B Gemon | Student in an Organized Health Care Education/Training Program | 4940 Eastern Ave, Baltimore, MD 21224-2735 | 2020-10-08 |
| 1235756800 | Lauren Kerrigan | Nurse Practitioner | 4940 Eastern Ave, Baltimore, MD 21224-2735 | 2020-06-30 |
| 1568086692 | Kathleen Campbell Mckenzie | Physician Assistant | 4940 Eastern Ave, Baltimore, MD 21224-2735 | 2020-06-04 |
| 1639791197 | Sharice Cheng | Physician Assistant | 4940 Eastern Ave, Baltimore, MD 21224-2735 | 2020-05-07 |
| 1679194799 | John Donald Giles | Nurse Practitioner | 4940 Eastern Ave, Baltimore, MD 21224-2735 | 2020-04-29 |
| 1598386971 | Meiyappan Udayappan | Student in an Organized Health Care Education/Training Program | 4940 Eastern Ave, Baltimore, MD 21224-2735 | 2020-04-27 |
| 1972123370 | Molly Elizabeth Maresca Atwood | Psychologist | 4940 Eastern Ave, Baltimore, MD 21224-2735 | 2020-04-26 |
| 1982224887 | Ofure Anita Akhiwu | Student in an Organized Health Care Education/Training Program | 4940 Eastern Ave, Baltimore, MD 21224-2735 | 2020-04-21 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710595517 | Lisa Farinelli | Registered Nurse | 251 Bayview Bldv, Baltimore, MD 21224 | 2020-07-17 |
| 1891303038 | Lorenzo Leggio | General Practice | Nih/nida, Bayview Campus, Brc, 251 Bayview Boulevard, Room 01a844, Baltimore, MD 21224 | 2020-07-14 |
| 1922622737 | Johns Hopkins Bayview Medical Center, Inc. | Community/Behavioral Health | 5500 E. Lombard Street, Room 1025, Baltimore, MD 21224 | 2020-06-08 |
| 1558995670 | Myeong Hyun Chae | Dentist | 7839 Eastern Ave, Baltimore, MD 21224 | 2020-02-27 |
| 1720627581 | Johns Hopkins Bayview Medical Center, Inc. | Clinic/Center | 5500 East Lombard Street, Room 1025, Baltimore, MD 21224 | 2019-12-27 |
| 1194288431 | Tawny Meagan Epperson | Counselor | 5500 E Lombard Street, Community Psychiatry, Child Mobile Treatment Services, Baltimore, MD 21224 | 2019-04-12 |
| 1437613163 | Johns Hopkins University | Internal Medicine | 5210 Eastern Avenue, Alpha Center, Baltimore, MD 21224 | 2019-01-28 |
| 1669993606 | Maria Giannas | Pharmacist | 6510 O'donnell St, Baltimore, MD 21224 | 2017-06-29 |
| 1588193437 | Heather Ann Sand | Social Worker | 1501 S Clinton Street, Mailstop Ct 05-13, Baltimore, MD 21224 | 2017-06-05 |
| 1912447822 | Jennifer Ann Maser Hermann | Counselor | 4637 Hudson Street, Baltimore, MD 21224 | 2017-02-27 |
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| Taxonomy Code | 2084A0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Addiction Medicine |
| A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |
| Notes: Source: American Osteopathic Board of Neurology and Psychiatry, 2007 [1/1/2008: definition added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649317264 | Marc Judah Fishman | Psychiatry & Neurology | 3800 Frederick Avenue, Na, Baltimore, MD 21229-3618 | 2007-01-31 |
| 1861599490 | Rhonda Lynn Allen | Psychiatry & Neurology | 5401 Loch Raven Blvd Fl 2, Baltimore, MD 21239-2902 | 2006-09-17 |
| 1508811936 | Maryland Treatment Centers, Inc. | Psychiatry & Neurology | 3800 Frederick Ave, Baltimore, MD 21229-3618 | 2006-05-24 |
| 1659333946 | David A. Gorelick | Psychiatry & Neurology | 5500 Nathan Shock Dr, Baltimore, MD 21224-6823 | 2006-04-04 |
| 1881080653 | Darryl M Coleman Md Pa | Psychiatry & Neurology | 2125 Maryland Ave, Suites 109 & 110, Baltimore, MD 21218-5634 | 2015-04-08 |
| 1003061771 | Priscilla Waldo Sheldon | Psychiatry & Neurology | 1001 W Pratt St, Baltimore, MD 21223-2679 | 2008-11-22 |
| 1205097391 | Aisosioya A Williams | Psychiatry & Neurology | 1501 Division St, Baltimore, MD 21217-3121 | 2008-06-20 |
| 1508950015 | Marian Currens | Psychiatry & Neurology | 827 Linden Ave, Baltimore, MD 21201-4606 | 2006-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740631951 | Carrie Schmitt | Psychiatry & Neurology | 8470 Dorsey Run Rd, Jessup, MD 20794-9486 | 2016-06-29 |
| 1871999276 | Bergand Group | Psychiatry & Neurology | 1803 Harford Rd, Fallston, MD 21047 | 2014-11-12 |
| 1578876264 | Belitehorizonmedicalcenter | Psychiatry & Neurology | 26825 Pointlook Out Road, Stee, Leonardtown, MD 20650 | 2010-07-22 |
| 1164688677 | Jack Laurence Wapner | Psychiatry & Neurology | 11100 Liberty Rd, Suite F, Randallstown, MD 21133-1026 | 2008-08-04 |
| 1003018813 | Donald Harry Taylor | Psychiatry & Neurology | 4545 Crain Hwy, Substance Abuse Services, White Plains, MD 20695-1050 | 2007-06-04 |
| 1831284769 | Syed Asif H Ali | Psychiatry & Neurology | 13102 Autumn Dr, Silver Spring, MD 20904-3307 | 2006-10-04 |
| 1952404840 | Samathanam N Abraham | Psychiatry & Neurology | 13207 Valley Dr, Rockville, MD 20850-3626 | 2006-09-06 |
| 1174634869 | Indu Mago Sud | Psychiatry & Neurology | 17958 Pond Rd, Ashton, MD 20861-9756 | 2006-08-31 |
| 1619082005 | Maryland Treatment Centers, Inc. | Psychiatry & Neurology | 14703 Avery Rd, Rockville, MD 20853-3605 | 2006-08-19 |
| 1063997708 | The Bergand Group LLC | Psychiatry & Neurology | 1300 York Rd, Lutherville, MD 21093-6016 | 2018-09-28 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.