Provider Demographics
NPI:1154641512
Name:KHURANA, NITASHA (B SC)
Entity Type:Individual
Prefix:MRS
First Name:NITASHA
Middle Name:
Last Name:KHURANA
Suffix:
Gender:F
Credentials:B SC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3047
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14302-3047
Mailing Address - Country:US
Mailing Address - Phone:857-636-0003
Mailing Address - Fax:
Practice Address - Street 1:214 LOCKPORT ST
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:NY
Practice Address - Zip Code:14174-1008
Practice Address - Country:US
Practice Address - Phone:716-745-3313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-09
Last Update Date:2010-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000062183500000X
PA441950183500000X
MA24843183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist