Provider Demographics
NPI:1871667204
Name:KHERA, GURBIR S (MD)
Entity Type:Individual
Prefix:DR
First Name:GURBIR
Middle Name:S
Last Name:KHERA
Suffix:
Gender:M
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:PO BOX 148
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-0148
Mailing Address - Country:US
Mailing Address - Phone:732-530-2900
Mailing Address - Fax:732-780-2804
Practice Address - Street 1:28 BRIAR HILL DR STE 4
Practice Address - Street 2:
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-3021
Practice Address - Country:US
Practice Address - Phone:732-530-2900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-18
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA046660002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3757609Medicaid
NJC48449Medicare UPIN
NJ536634Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER