Provider Demographics
NPI:1689026023
Name:KHANGURA, GURNEET (DPM)
Entity Type:Individual
Prefix:
First Name:GURNEET
Middle Name:
Last Name:KHANGURA
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 FRUIT ST
Mailing Address - Street 2:YAWKEY 3F
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-2621
Mailing Address - Country:US
Mailing Address - Phone:617-726-3487
Mailing Address - Fax:617-724-3384
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:YAWKEY 3F
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2621
Practice Address - Country:US
Practice Address - Phone:617-726-3487
Practice Address - Fax:617-724-3384
Is Sole Proprietor?:No
Enumeration Date:2016-07-11
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH59.000611213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist