Provider Demographics
NPI:1801566369
Name:KHURANA, GAGANJOT SINGH
Entity type:Individual
Prefix:
First Name:GAGANJOT
Middle Name:SINGH
Last Name:KHURANA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14125 W LISBON RD
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-1634
Mailing Address - Country:US
Mailing Address - Phone:262-364-7175
Mailing Address - Fax:262-806-4244
Practice Address - Street 1:14125 W LISBON RD
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-1634
Practice Address - Country:US
Practice Address - Phone:262-364-7175
Practice Address - Fax:262-806-4244
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-16
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No344600000XTransportation ServicesTaxi