Provider Demographics
NPI:1225036882
Name:SINGH, GUNWANT (MD)
Entity Type:Individual
Prefix:DR
First Name:GUNWANT
Middle Name:
Last Name:SINGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131-29 135TH PLACE
Mailing Address - Street 2:
Mailing Address - City:SOUTHB OZONE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11420-3502
Mailing Address - Country:US
Mailing Address - Phone:718-843-2618
Mailing Address - Fax:718-322-6429
Practice Address - Street 1:118-03 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND HILLS
Practice Address - State:NY
Practice Address - Zip Code:11420-3502
Practice Address - Country:US
Practice Address - Phone:718-843-2618
Practice Address - Fax:718-322-6429
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY221641-1207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02599342Medicaid
244AX2OtherEMPIRE BCBS
NY06656OtherGHI MEDICARE
2276226OtherFIRST HEALTH
5571764OtherFIRST HEALTH
2276226OtherFIRST HEALTH
5571764OtherFIRST HEALTH