Provider Demographics
NPI:1467726588
Name:JITENDRA SINGH, MD, P.C.
Entity Type:Organization
Organization Name:JITENDRA SINGH, MD, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JITENDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-761-9500
Mailing Address - Street 1:115 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:GLENS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12801-3630
Mailing Address - Country:US
Mailing Address - Phone:518-761-9500
Mailing Address - Fax:518-761-9525
Practice Address - Street 1:115 MAPLE ST
Practice Address - Street 2:
Practice Address - City:GLENS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12801-3630
Practice Address - Country:US
Practice Address - Phone:518-761-9500
Practice Address - Fax:518-761-9525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-07
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY245038261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
J400000137OtherMEDICARE PTAN