Provider Demographics
NPI:1235166760
Name:SINGAL, BRENDA BOUCHARD (MD)
Entity Type:Individual
Prefix:DR
First Name:BRENDA
Middle Name:BOUCHARD
Last Name:SINGAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BRENDA
Other - Middle Name:LYNN
Other - Last Name:BOUCHARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-812-4240
Mailing Address - Fax:717-848-5520
Practice Address - Street 1:2050 S QUEEN ST
Practice Address - Street 2:STE 100
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-4829
Practice Address - Country:US
Practice Address - Phone:717-812-4240
Practice Address - Fax:717-848-5520
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2014-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD050463L208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA233273OtherMAMSI-WMG
PA4509899OtherAETNA
MD543235OtherCAREFIRST MD BCBS
PAP002872OtherGATEWAY-WMG
PA030067OtherJOHNS HOPKINS
PA37210OtherGEISINGER
PA20010754OtherAH MERCY-WMG CARLISLE RD
PA001468012Medicaid
PA1142402OtherAH MERCY-WMG QUEEN ST
PA770895OtherHIGHMARK BLUE SHIELD
PA81002OtherUNISON-WMG
PA02110002OtherCAPITAL BLUE CROSS-WMG
MD543235OtherCAREFIRST MD BCBS
PA001468012Medicaid