Provider Demographics
NPI:1083193213
Name:SINGH, PRINCE N (FNP-C)
Entity Type:Individual
Prefix:
First Name:PRINCE
Middle Name:N
Last Name:SINGH
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:PRINCE
Other - Middle Name:N
Other - Last Name:SINGH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP-C
Mailing Address - Street 1:456 E PARK AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561-3633
Mailing Address - Country:US
Mailing Address - Phone:516-234-3119
Mailing Address - Fax:
Practice Address - Street 1:257 W PARK AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:NY
Practice Address - Zip Code:11561-3222
Practice Address - Country:US
Practice Address - Phone:516-493-9975
Practice Address - Fax:516-493-9976
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-08
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY343429363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY343429Medicaid