Provider Demographics
NPI:1245401041
Name:THAKRAL, HARJOT KAUR (MD)
Entity Type:Individual
Prefix:MISS
First Name:HARJOT
Middle Name:KAUR
Last Name:THAKRAL
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 1:143 LONGWATER DR
Mailing Address - Street 2:
Mailing Address - City:NORWELL
Mailing Address - State:MA
Mailing Address - Zip Code:02061-1683
Mailing Address - Country:US
Mailing Address - Phone:781-878-5200
Mailing Address - Fax:781-681-1713
Practice Address - Street 1:143 LONGWATER DR
Practice Address - Street 2:
Practice Address - City:NORWELL
Practice Address - State:MA
Practice Address - Zip Code:02061-1683
Practice Address - Country:US
Practice Address - Phone:781-878-5200
Practice Address - Fax:781-681-1713
Is Sole Proprietor?:No
Enumeration Date:2008-03-19
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA243342207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
7353962OtherCIGNA
04-2297845OtherMULTI-PLAN/PHCS
MAJ47849OtherBCBSMA
9599956OtherAETNA
MAAA433119OtherHARVARD PILGRIM
04-2297845OtherUNITED HEALTH CARE
MA1245401041Medicaid
04-2297845OtherGIC/UNICARE
MA1245401041OtherNEIGHBORHOOD HEALTH PLAN
MA1245401041OtherFALLON HEALTH CARE
MA757054OtherTUFTS & TMP
04-2297845OtherTRICARE
04-2297845OtherHCVM
MAAA433119OtherHARVARD PILGRIM