Provider Demographics
NPI:1023193323
Name:SINGH, MAHAVIR (MD)
Entity Type:Individual
Prefix:
First Name:MAHAVIR
Middle Name:
Last Name:SINGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MAHAVIR
Other - Middle Name:
Other - Last Name:SINGH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:3074 9 W SOUTH
Mailing Address - Street 2:
Mailing Address - City:NEW WINDSOR
Mailing Address - State:NY
Mailing Address - Zip Code:12553
Mailing Address - Country:US
Mailing Address - Phone:845-561-8902
Mailing Address - Fax:845-561-8910
Practice Address - Street 1:3074 9 W SOUTH
Practice Address - Street 2:
Practice Address - City:NEW WINDSOR
Practice Address - State:NY
Practice Address - Zip Code:12553
Practice Address - Country:US
Practice Address - Phone:845-561-8902
Practice Address - Fax:845-561-8910
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY185688207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
141749057OtherTAX ID
141749057OtherTAX ID
141749057OtherTAX ID
05G151Medicare ID - Type Unspecified