Gandolfo, John V
Gandolfo, John V is an individual health care provider with primary practice located at One Roosevelt Avenue Suite 204 , Peabody MA 01960. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Gastroenterology. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Gandolfo, John V can be contacted via phone (978) 536-7778.Contact Information
Primary practice address
One Roosevelt Avenue Suite 204
Peabody MA 01960
Phone: (978) 536-7778
Fax: (978) 536-2998
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 48148 | Massachusetts |
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | 48148 | Massachusetts |
Profile Details
| NPI number | 1548332992 |
|---|---|
| LBN Legal business name | Gandolfo, John V |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 14th, 2006 |
| Last updated | Sep 11th, 2025 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1548332992 | NPPES |
| Massachusetts | Other | J02927 | BLUE SHIELD OF MA |
| Massachusetts | Other | 61925 | BLUE SHIELD OF MA |
| Massachusetts | Other | 048148 | BLUE SHIELD OF MA |
| Massachusetts | MEDICAID | 6180884 | BLUE SHIELD OF MA |
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