Provider Demographics
NPI:1013008309
Name:PENINSULA NEUROLOGY LTD
Entity Type:Organization
Organization Name:PENINSULA NEUROLOGY LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAJINDER
Authorized Official - Middle Name:P
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:757-872-9797
Mailing Address - Street 1:802 LOCKWOOD AVE STE A
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23602-4479
Mailing Address - Country:US
Mailing Address - Phone:757-872-9797
Mailing Address - Fax:757-872-9711
Practice Address - Street 1:802 LOCKWOOD AVE STE A
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23602-4479
Practice Address - Country:US
Practice Address - Phone:757-872-9797
Practice Address - Fax:757-872-9711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101041732174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7116497Medicaid
VA465662OtherANTHEM
VAP00205034OtherRAILROAD MEDICARE
VA130019108OtherRAILROAD MEDICARE
VA010006279Medicaid
VA394415OtherANTHEM
VA394415OtherANTHEM
VA130019108OtherRAILROAD MEDICARE
VAG30728Medicare UPIN
VAP00205034OtherRAILROAD MEDICARE
VA130000714Medicare PIN