Provider Demographics
NPI:1972184422
Name:SHINA, SIMARDEEP KAUR (MD)
Entity Type:Individual
Prefix:DR
First Name:SIMARDEEP
Middle Name:KAUR
Last Name:SHINA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SIMARDEEP
Other - Middle Name:KAUR
Other - Last Name:KHANGURA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:730 CLINTON ST
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-2404
Mailing Address - Country:US
Mailing Address - Phone:516-500-5851
Mailing Address - Fax:
Practice Address - Street 1:56-45 MAIN STREET
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355
Practice Address - Country:US
Practice Address - Phone:718-670-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-16
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program