Provider Demographics
NPI:1346430600
Name:SINGH, NIDHI (MD)
Entity Type:Individual
Prefix:MS
First Name:NIDHI
Middle Name:
Last Name:SINGH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 LAUREL AVENUE
Mailing Address - Street 2:ST LUKE'S CORNWALL HOSPITAL, BUSINESS OFFICE
Mailing Address - City:CORNWALL
Mailing Address - State:NY
Mailing Address - Zip Code:12518-1403
Mailing Address - Country:US
Mailing Address - Phone:845-458-4958
Mailing Address - Fax:845-458-4970
Practice Address - Street 1:70 DUBOIS STREET, 5TH FLOOR
Practice Address - Street 2:ST LUKE'S CORNWALL HOSPITAL DBA GATEWAY HOSPITAL PHYSIC
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-4825
Practice Address - Country:US
Practice Address - Phone:845-568-2827
Practice Address - Fax:845-568-2851
Is Sole Proprietor?:No
Enumeration Date:2007-08-01
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI50809-020207R00000X
NY003290207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI34945900Medicaid
WI60698OtherDEAN HEALTH INSURANCE
WI60698OtherDEAN HEALTH INSURANCE
WI042954340Medicare PIN