Provider Demographics
NPI:1053663328
Name:SINGHAL, MRUDULA
Entity Type:Individual
Prefix:MISS
First Name:MRUDULA
Middle Name:
Last Name:SINGHAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2960 HOMESTEAD RD
Mailing Address - Street 2:APT# 3
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95051-5254
Mailing Address - Country:US
Mailing Address - Phone:312-813-7433
Mailing Address - Fax:
Practice Address - Street 1:1920 OLD SPRINGVILLE RD
Practice Address - Street 2:
Practice Address - City:CENTER POINT
Practice Address - State:AL
Practice Address - Zip Code:35215-5858
Practice Address - Country:US
Practice Address - Phone:312-813-7433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-10
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034727225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist