Provider Demographics
NPI:1558800599
Name:SINGH, AMY JAIMANI (MPH, PA-C)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:JAIMANI
Last Name:SINGH
Suffix:
Gender:F
Credentials:MPH, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 FRANKLIN AVE
Mailing Address - Street 2:SUITE 357
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-8600
Mailing Address - Country:US
Mailing Address - Phone:718-738-4338
Mailing Address - Fax:718-845-5896
Practice Address - Street 1:600 FRANKLIN AVE
Practice Address - Street 2:SUITE 357
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-8600
Practice Address - Country:US
Practice Address - Phone:718-738-4338
Practice Address - Fax:718-845-5896
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-22
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020667363A00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant