Provider Demographics
NPI:1376798645
Name:SINGHAL, SUKRITI (MD)
Entity Type:Individual
Prefix:DR
First Name:SUKRITI
Middle Name:
Last Name:SINGHAL
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 1:218 MAIN ST
Mailing Address - Street 2:PMB 486
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-6108
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:218 MAIN ST
Practice Address - Street 2:PMB 486
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-6108
Practice Address - Country:US
Practice Address - Phone:201-615-7091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-29
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY231524207RP1001X
ORMD154400207RP1001X
WAMD00043828207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500652517Medicaid
OR500652517Medicaid
ORR164879Medicare PIN