Healthcare Provider Details

I. General information

NPI: 1316433345
Provider Name (Legal Business Name): DHEERAJ KHURANA CARDIOLOGY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2018
Last Update Date: 07/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8912 WOODHAVEN BLVD
WOODHAVEN NY
11421-2614
US

IV. Provider business mailing address

320 CONTINENTAL DR
NEW HYDE PARK NY
11040-1006
US

V. Phone/Fax

Practice location:
  • Phone: 917-361-5664
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DHEERAJ KHURANA
Title or Position: MD
Credential:
Phone: 917-361-5664