Provider Demographics
NPI:1164467668
Name:KHURANA, SHALINI (MD)
Entity Type:Individual
Prefix:
First Name:SHALINI
Middle Name:
Last Name:KHURANA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:
Practice Address - Street 1:55 MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837-6343
Practice Address - Country:US
Practice Address - Phone:570-523-3264
Practice Address - Fax:570-523-3465
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA070811208000000X
MDD63517208000000X
PAMD459700208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
H57036Medicare UPIN