Healthcare Provider Details

I. General information

NPI: 1235214016
Provider Name (Legal Business Name): GURJIT K KHURANA-HERSHEY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 01/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVE MLC 7037
CINCINNATI OH
45229-3039
US

IV. Provider business mailing address

3333 BURNET AVE MLC 7037
CINCINNATI OH
45229-3039
US

V. Phone/Fax

Practice location:
  • Phone: 513-636-8670
  • Fax:
Mailing address:
  • Phone: 513-636-8670
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35.072512
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number35.072515
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: