Healthcare Provider Details

I. General information

NPI: 1295261881
Provider Name (Legal Business Name): MOHIT M KUKREJA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2017
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 ELECTRIC AVE
LEWISTOWN PA
17044-1369
US

IV. Provider business mailing address

100 N ACADEMY AVE
DANVILLE PA
17822-4903
US

V. Phone/Fax

Practice location:
  • Phone: 717-242-8124
  • Fax: 717-242-8125
Mailing address:
  • Phone: 717-242-8124
  • Fax: 717-242-8125

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD492530
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: