Provider Demographics
NPI:1588864433
Name:KHERA, JENA R (MD)
Entity type:Individual
Prefix:DR
First Name:JENA
Middle Name:R
Last Name:KHERA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RAJINDER
Other - Middle Name:RUTH
Other - Last Name:KHERA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-851-5503
Mailing Address - Fax:717-851-5507
Practice Address - Street 1:212 ROSEDALE DR
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:PA
Practice Address - Zip Code:17345-1023
Practice Address - Country:US
Practice Address - Phone:717-851-5503
Practice Address - Fax:717-851-1905
Is Sole Proprietor?:No
Enumeration Date:2007-07-19
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4321162084N0400X, 2084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1984202OtherHIGHMARK BLUE SHIELD
PA212022OtherJOHNS HOPKINS
PA223432OtherUNISON-WMG
PA113216OtherGEISINGER
PA1567151OtherGATEWAY-WMG
PA20068869OtherAMERIHEALTH MERCY-WMG
PA50072068OtherCAPITAL BLUE CROSS-WMG
PA9576099OtherAETNA
MD909862OtherCAREFIRST MD BCBS
PA50072068OtherCAPITAL BLUE CROSS-WMG